Abstract: What eye doctors think of the dry eye treatment status quo

Summary of how satisfied eye doctors are with their treatments.

Couple of useful gleanings:

1) It may seem to you that your doctor does not understand how much pain you're in or doesn't take you seriously. However, clearly, across the board, ophthalmologists (and this is including the minimally-dry-eye-literate ones, since apparently only 1.53 corneal specialists responded to this - oh and by the way, why did they send it to only 51 of those? hm) know that the treatments they're giving are inadequate. They know you're not happy and they want better treatments too.

2) If you have ever felt like you're the only one out there with this problem... take a look at this. 96% of doctors responding to this survey treat at least 4 People Like You Or Worse every month. Now, given how eye doctors think about corneas, they're probably only counting the people whose corneas are actually visibly in bad shape. If they have some of those, they probably have even more of the classic "I hurt a lot worse than I look under a slitlamp" patients. You are not alone. Anything but.


Ophthalmologist Perceptions Regarding Treatment of Moderate-to-Severe Dry Eye: Results of a Physician Survey.
Eye Contact Lens.. [Epub ahead of print]
Asbell PA, Spiegel S.
From the Department of Ophthalmology (P.A.A.), Mount Sinai School of Medicine, New York, NY; and Advanstar Communications (S.S.), New York, NY.

PURPOSE:: To understand ophthalmologists' current perceptions and treatment of patients with moderate-to-severe dry eye disease (DED).

SETTING:: Online survey.

METHODS:: The online survey was sent to 7,882 ophthalmologists, including 51 corneal specialists, throughout the United States from October 9 to 21, 2008. The response rate was 3.1% (n = 245), typical for this type of survey. Only ophthalmologists who treated four or more moderate-to-severe DED patients per month (235 of 245 [96%]) were asked to complete the survey.

RESULTS:: Ninety-four percent of respondents agreed that more treatment options are needed for moderate-to-severe DED. Corneal specialists were more likely to strongly agree (63%) than general ophthalmologists (54%). Only 33% overall felt that current therapies were extremely or very effective for moderate DED and only 5% for severe disease. Ninety-two percent agreed that multiple therapeutic agents are needed to manage moderate-to-severe DED. The respondents prescribed or recommended a mean of 3.2 different treatments (standard deviation = 1.2) for moderate DED patients over the course of a year and 4.9 (standard deviation = 2.2) for patients with severe DED. The most highly ranked goals for treatment of moderate-to-severe DED patients were maintaining and protecting the ocular surface (ranked 1 or 2 x 74%) and lubricating and hydrating the ocular surface (ranked 1 or 2 x 67%). Corneal specialists ranked maintaining and protecting the ocular surface even more highly (ranked 1 or 2 x 82%).

CONCLUSIONS:: Results reflected the difficulty of treating moderate-to-severe DED, the importance of using multiple treatment approaches, the limitations of current treatment options, and the need for additional treatment options.