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    5 things you need to know about TFOS DEWS II



    Leslie O’Dell, OD, FAAO

    Optometry Times Editorial Advisory Board Member

    Dry eye symptoms remain one of the tops reasons patients seek eye care. Dry eye is a challenging disease to diagnose and treat due the complexity, variability, and chronicity of the disease.

    TFOS DEWS II provides the clinician with a step-wise approach to diagnosis and treatment based on thousands of studies reviewed over the two-to-three year time period in which is document was created.

    The diagnosis section lays the groundwork with which to base our exams, including triaging the patient to differentiate dry eye disease from other ocular surface conditions. It then goes on to guide the clinician on the best methods for uncovering both the signs and the symptoms of dry eye.

    Utilizing a validated questionnaire with the Dry Eye Questionnaire 5 (DEQ-5) or Ocular Surface Disease Index (OSDI) is recommended and an easy addition to the exam. T

    FOS DEWS II then states that non-invasive tear break-up time (NIBUT), tear film osmolarity, or ocular surface staining patterns of the corneal and conjunctiva should be used for the clinical signs of DED with easily defined results. Additional testing is required from here to better classify the subtype of disease (aqueous vs. evaporative) as well as the stage of disease to determine the patient's best treatment to optimize outcomes.

    Proper diagnosis is critical to improve treatment outcomes. The sequence of testing used is important as well as discussed in TFOS DEWSII, with non-invasive testing to be performed first, followed by more invasive testing.

    What I am going to change after reading TFOS DEWS II? My intake survey and utilization of NIBUT.

    Related: How to use tear osmolarity to help treat dry eye disease

    Katherine M. Mastrota, MS, OD, FAAO, Dipl ABO
    Director of Optometry, New York Hotel Trades Council, Hotel Association of New York City, Health Center, Inc.


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