Device-based therapies as a boost of conventional treatment in dry eye disease

ABSTRACT

Introduction

Dry eye disease (DED) is a multifactorial chronic condition with a broad spectrum of symptoms that can affect daily activities and quality of life.

Areas covered

New treatment approaches that target more systematically distinct parts of the pathophysiology would present new potential to effectively regulate signs and symptoms of DED. In this review, a comprehensive list of device-based treatments has been provided, according to their mechanism of action.

Expert opinion

Given the variability and complexity of DED, adjuvant treatments should be considered as a boost for patients who do not respond to first-line therapy. Most of those devices primarily target meibomian glands, using heat or mechanical energy to restore normal meibum flow. Although several treatments have been discussed in this review, further studies are needed to identify new options, evaluate current therapies in randomized clinical trials more extensively, and identify which subtypes of DED could benefit from any given therapy.

KEYWORDS:

• Dry eye disease
• meibomian gland dysfunction
• eyelid
• treatment
• intense pulsed light
• low level light therapy

Article highlights

• This article reviews the available device-based therapies in the treatment of dry eye disease (DED).

• DED is a long-standing disorder that requires chronic treatment to recover and sustain the homeostasis of the ocular surface system.

• Over the past few years, the development of treatments for evaporative dry eye and meibomian gland dysfunction has been increased.

• The majority of DED devices work primarily on meibomian gland disfunction by applying heat or mechanical energy to express the glands and reestablish the meibum’s normal flow.

• Given the complexity and diversity of DED, patients who respond poorly to first-line therapy should be given a fair chance with adjuvant therapies.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This research received no external funding.