Dry Eye Disease (DED) is an inflammatory disease affecting over 16 million people in the U.S. and 340 million worldwide. It may be vastly under-reported because early-stage dry eye sufferers think it is normal and seek comfort with OTC eye drops. By postponing a medical exam and treatment, the disease can progress more rapidly to advanced stages with serious quality of life effects.
The disease is multifactorial. The treatments address multiple fronts and vary according to the stage of the disease. Lubricating eye drops and anti-inflammatory treatments help reduce symptoms for comfort and increase tear production. But regenerative biologics claim to address the root cause of the inflammatory response by modulating the detrimental immune response that underlies inflammation. And regenerative biologics help the body repair damage and regenerate the ocular surface epithelium.
The underlying cause of DED is most often the disruption of a healthy tear film due to an inflammatory response. The tear film is three layers comprised of lipid (fatty), aqueous fluid and mucin (mucus). Each layer plays a role in producing the right amount of tears with the right composition and viscosity to allow the tear film to adhere to the cornea and spread evenly with every blink. An unhealthy tear film can cause inadequate tear production or increased tear evaporation, putting the ocular surface epithelium at risk.
Contributing factors: aging, certain medications, certain immune disorders such as Sjogren syndrome, RA and lupus; contact lens use or laser eye surgery and being female (women have double the rate of DED than men according to a study from NEI). Exacerbating conditions include staring at digital screens due to a lack of blinking, dry environments, low fluid intake, lack of sleep, diets low in omega 3 fatty acids or vitamin A and smoking. Sometimes chronic disease contributes to DED and other times, the medication used to treat a disease is the culprit. Examples of medication that contribute to DED are the preserved drops in the treatment of glaucoma, antihistamines, sleeping pills, blood pressure medications like beta-blockers or diuretics and anti-anxiety medications. Various chronic diseases are associated with dry eye disease, such as meibomian gland dysfunction, diabetes, thyroid disorders, etc.
The Ocular Regenerative Medicine Institute at Harvard is leading the effort to develop novel methods to regenerate eye tissues for various diseases. Let us hope that regenerative medicine is the breakthrough that can help the millions of us suffering from dry eye disease.
• Deborah Kotob
Pro to Pro Director