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    5 things you need to know about TFOS DEWS II



    Bill Townsend, OD, FAAO

    Optometry Times Editorial Advisory Board Member

    The release of TFOS DEWS II report is a welcome event for those of us who have interest in and manage dry eye disease. The broad spectrum of contributors from many diverse professions and geographic locations speaks to the universality of dry eye disease. It reminds us that dry eye disease is indeed a global concern. TFOS DEWS II reflects some of advancements that have been made in our understanding of DED since the release of TFOS DEWS I in 2007.

    Many of the factors underlying DED as reported in TFOS DEWS I are also found in TFOS DEWS II. These include:

    • Ocular symptoms

    • Inflammation

    • Hyper-osmolarity

    • Damage to the ocular surface

    TFOS DEWS II contains important additions: loss of homeostasis and neurosensory abnormalities. The concept of failure to maintain homeostasis is widely accepted as an underlying factor in many systemic disease states, notably diabetes, hypertension, and thyroid disease. The model of the “lacrimal functional unit” has helped us to understand how loss of homeostasis underlies virtually all forms of DED.

    Interestingly, “visual disturbances,” which was part of TFOS DEWS I, was not included in TFOS DEWS II. This concept is inherent in the “lacrimal functional unit” model. Visual disturbances such as blurring are common findings in dry eye and likely fall within the general category of “neurosensory abnormalities.” I mention this only to emphasize that when patients report blurring, DED is often the underlying cause and should be address in the differential. 

    The TFOS DEWS II report is available for download at no cost, and I encourage my colleagues to read it. It sheds important light and offers new evidence about on one of the conditions that ODs commonly encounter. Kudos to this distinguished group for their work leading to this publication. I especially congratulate the numerous ODs who participated in this project, and special thanks for their efforts on behalf of eye care and our profession.

    Related: Understanding the link between MGD and OSD

    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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