Beyond DEWS II

An overview of the latest advances in dry eye disease management, treatment innovations, and insights into the condition’s pathophysiology since the landmark TFOS DEWS II report.

Quillan M. Austria, MD, and Christopher E. Starr, MD

Cataract and Refractive Surgery Today

In 2017, the Tear Film and Ocular Surface Society (TFOS) published the TFOS Dry Eye Workshop II (DEWS II) in The Ocular Surface.1-9 The objectives were to update the definition of dry eye disease (DED) established in DEWS I and critically review and integrate the substantial volume of literature on various aspects of DED, including risk factors, pathophysiology, management, and future therapies. Since the publication of DEWS II, the field of DED has grown considerably, with more than 8,000 studies added to the literature. This article highlights some of the significant advances since the publication of DEWS II and seeks to increase awareness of future interventions in DED treatment.

Optimizing the Business of Dry Eye

Practical guidance for success.

Patti Barkey, COE

Cataract and Refractive Surgery Today

Dry Eye University (dryeyeuniversity.com) was established with the aim of elevating the business of dry eye disease (DED) in modern eye care practices. With the support of industry partners, program 26 sold out in February 2024 and was attended by ophthalmologists, optometrists, private equity teams, and practice CEOs with their staff. DED is big business. An estimated 36 million individuals have DED in the United States, although the reported prevalence ranges greatly. As the CEO of a practice that specializes in DED care, I have found that at least eight out of 10 patients who walk through our doors have some signs and/or symptoms of DED. In contrast, my work with practices all over the country through Dry Eye University and industry partner relationships suggests that only 3% to 5% of US practices embrace DED patients. The goals of care are to halt the progression of this lifelong disease and increase patient comfort. In a business sense, however, patients with chronic conditions such as DED and glaucoma are akin to annuities on a practice’s productivity sheet year after year. This article shares tips on how to optimize a DED business. FINANCIAL CONSIDERATIONS Advertising.

Practice Makes Progress

Marion Munk, MD, and Justis P. Ehlers, MD

Retina Today

It’s always fascinating when trendy technology seeps into health care. While working on this issue, our news feeds were overrun with stories of surgeons using Apple’s new Vision Pro in the OR.1 According to the press release, a nurse used the device to help with instrument selection, data visualization, and procedure monitoring.1 Cool stuff, and even if you aren’t an Apple aficionado, you have to admit this “spatial computer” is impressive.2 The news caught our eyes, but it didn’t surprise us because the field of retina was way ahead of the curve with this technology. The first ophthalmic exoscope—the Beyeonics One visualization system—that integrates augmented reality into a surgical headset was installed into an ophthalmic surgical suite years ago.3 Not only that, but the company recently announced the integration of intraoperative OCT into the headset, making it something of a spatial computer itself—for the surgeon.4 Retina has always been a field defined by technologic advancement, and our imaging tools are a great example. In an explosion of innovation in the early 2000s, we saw the advent of 3D visualization in the OR, intraoperative OCT, and OCT angiography (OCTA). Since then, it has been a slow march of improvement. For example, the January/February issue highlighted the addition of fluorescein angiography to surgical 3D heads-up displays. Other issues have touched on scanning laser ophthalmoscope-based multimodal fundus imaging and ultra-widefield technologies for the detection of diabetic eye disease. To catch up on these articles, see Further Reading. Some technology still in the pipeline may be poised to hit the clinic in the next few years; K. Bailey Freund, MD, and others have been lecturing on high-resolution OCT for a while now, with Retina Today following closely since its inaugural issue in 2006.5 While researchers work on fine-tuning the next generation, we asked experts to share their insights to help you perfect your skills with the imaging tools at your disposal.