TFOS DEWS II - Monitoring dry eye disease progression and management

Few studies have monitored changes in DED signs and symptoms over time. New electronic technologies, such as smartphones or other handheld devices, have been tested recently to capture symptom information in “real time” rather than rely on reports from a recall period, thus aiding patient monitoring [481].

The Women's Health Study and Physicians' Health Study cohorts, revealed worsening of vision-related symptoms in 29% of the subjects since diagnosis (on average 10.5 years). In multivariable logistic regression models for visual symptoms, spending >$20 (USD) per month on DED treatments, presence of a history of severe DED symptoms, and use of systemic beta-blockers were significantly associated with patient-reported visual worsening. Patients who reported severe symptoms of DED in the past were more likely to report worsening and to have corneal staining, suggesting that this might be a clinically relevant indicator of the probability of visual/OSD progression [482]. More prospective studies monitoring visual changes during the natural course of DED, and following treatment, are needed in the future.