Abstract:
TFOS published approximately 2 years ago the DEWS II report, which is a major revision of the
first version. One of the principal highlights of the workshop is the new definition, where the key
words are homeostasis, osmolarity, inflammation. The signs and symptoms of dry eye did not
change over the years, however our structured approach allows better and more structured
diagnosis. Special attention should be given to the history, as most of the patients have severe
complains, even without clinical signs on standard examination. There are number of
questionnaires, but looks like that OSDI is still the most widely used one. There are some new
highlights on the comfort – visual, perceptual and cosmetic, and related specific questions to reveal
the problems. Meibomian glands and their anatomical and functional characteristics are very hot
topic with special attention payed to Demodex. When the diagnosis is clear a proper management
is required. A range of measures are presented in diagrams and tailor made treatment approach is
advised in order to manage every specific case.
The purpose of presentation is to highlight the key points to guide the busy contact lens practitioner
in the everyday clinical practice. The highlights are as follows:
History: precise the character and presentation of the symptoms of CL wearers.
Clinical examination: Meibomian glands/lid margins, anterior ocular surface with TBUT
(Schirmer’s if needed), additional methods if required and available.
Therapeutic decision: tailor made approach with good combination of drops and/or contact lenses,
for each individual patient.
Hopefully the clinical interpretation of DEWSII will facilitate a new prospective and provide
several take home messages how to diagnose, manage and follow up patients with dry eye of any
kind.
