Optometrist Role in Dry Eye Disease Management

Kelly K. Nichols, OD, MPH, PhD


June 28, 2021

Optometrists and other eye care professionals today have access to a wide range of treatments and diagnostic tools to help the growing number of patients with dry eye disease (DED), but that was not always so, according to Dr Kelly Nichols, dean of the University of Alabama at Birmingham School of Optometry.

The FDA's first approval of a treatment for DED came in 2003; more than a decade passed with no prescription treatments being added to optometrists' pharmacopeia, but since then, the field has made rapid gains. Three medications have been approved in the past 5 years, and approval for a fourth is anticipated later in 2021.

Dr Nichols and other optometrists sense an unmet need in patients who seek care by going to pharmacies stocked with vast selections of over-the-counter artificial tears. In many cases, those widely accessible treatments may be insufficient to treat their symptoms. Her "mantra" for clinicians: "Optometrists should ask, look, and then do something for their patients."

The team of clinicians and researchers who first defined DED believed that there were two distinct tear film conditions: aqueous deficient (lack of water) or evaporative (insufficient mucins or lipids). Now those conditions are seen as existing in combination. With the array of medications now available, clinicians are empowered to confront this increasingly prevalent disease head-on in the optometry and ophthalmology setting.


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