What is Dry Eye Disease?
Dry eye disease (DED) was defined by the Dry Eye Workshop (DEWS) study group in 2007 as “a multi-factorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by tear film hyperosmolarity and inflammation of the ocular surface.”
Another, more simple, definition from 2009 described it as “a disease caused by conditions that either increase evaporation of the tear film or decrease tear production with resulting increase in tear film osmolarity (hyperosmolarity) leading to inflammation in the eye, damage, and symptoms.” DED is a common condition: 23 million patients in the United States report frequent Dry Eye symptoms, and more than 50% of contact lens wearers report DED symptoms.
At the onset, most patients notice a foreign body sensation, contact lens intolerance or have a shorter contact lens wearing tolerance. That’s a sign that you need an appointment for a Dry Eye workup, and once under control, we will fit the patient with new contacts in most cases.
Diagnosing Dry Eye Disease
Today, therapeutic options are abundant for the treatment of patients with DED and ocular surface disease (OSD). The ability to differentially diagnose not only the presence of Dry Eye Disease but to determine the causative factors (especially evaporative vs aqueousdeficient disease) can significantly increase our success rates with regard to managing this disease. Fortunately, technologies geared toward appropriate DED diagnosis have developed along with treatment modalities. In this post, I will review one of the most advanced and useful technologies currently available for the diagnosis of DED.
The RPS InflammaDry Detector (Rapid Pathogen Screening) is designed to detect matrix mettaloproteinase 9 (MMP-9), an inflammatory marker that is known to be elevated in patients with DED. MMP-9 is a cytokine produced by epithelial cells experiencing inflammation. It is the only test of this kind on the market and has a sensitivity of 85% and specificity of 94%. The test is easy to administer and no anesthetic is required.
A patient’s tear sample is taken from the inferior palpebral conjunctiva. Once the tears are collected, the applicator is dipped into a solution for 10 to 15 seconds. This solution is able to detect MMP-9 within the tears. A red line appears on the applicator if the tears are positive for MMP-9. A blue line will appear for negative results, and no lines will appear if the test is invalid.
The test can be administered in office and takes about 10 minutes from start to finish for results. Positive results indicate beginning anti-inflammatory therapy to improve the patient’s ocular comfort and health while reducing DED symptoms. Currently, the device is awaiting final FDA approval.
We all work hard, staying up with the latest technology options that can help diagnose and treat our patients suffering from Dry Eye Disease. I have had many patients tell me they aren’t able to wear contacts due to their dryness issues. With proper testing and treatment of DED, I’ve been able to help these patients become part time and full time contact lens wearers. One of the newest tests to the market is the RPS InflammaDry Detector. North Suburban Vision Consultants is an Accredited TearLab Dry Eye Center.
To find out more about the treatment of Dry Eye Disease, please read the article by Dr. Barry Eiden, Dr. Robert Davis and me in the May 2013 issue of Advanced Ocular Care at: http://eyetubeod.com/2013/05/latest-technologies-in-the-diagnosis-of-ded-and-osd#sthash.SIaJmCo4.dpuf
If you are suffering from these symptoms, I would recommend making an appointment with us today. Or call (847) 412-0311.