Vision Community Recognizes July as Dry Eye Awareness Month with a Capitol Hill
Briefing, Screening, and Poster Session
On July 12, the Alliance for Eye and Vision Research (AEVR) and the Tear Film & Ocular Surface Society (TFOS) joined with the vision community and coalition partners (see bottom box) in recognizing July as Dry Eye Awareness Month with a Congressional Briefing entitled Dry Eye: An Updated Definition, A Greater Impact on Vision Health, a “Test Your Tears” Dry Eye Screening, and a poster presentation by dry eye clinicians and researchers. The following day, and under the auspices of the National Alliance for Eye and Vision Research (NAEVR), the speakers and researchers conducted visits with their Congressional delegations.
Left to right: The Briefing faculty consisted of Paul Karpecki, OD., FAAO (Kentucky Eye Institute), Susan Vitale, PhD, MHS (National Eye Institute), Janine Austin-Clayton, MD (National Institutes of Health), and David A. Sullivan, MS, PhD, FARVO (Schepens Eye Research Institute/Harvard Medical School and Founder, Tear Film & Ocular Surface Society, TFOS
About Dry Eye
Dry eye is one of the most frequent causes of patient visits to eye care providers, This disease has an important impact on healthcare policy as it affects more than 30 million Americans and costs the United States healthcare system $3.8 billion, with a $55.4 billion cost to society from diminished productivity.
Dry eye occurs when the eye does not produce tears properly or when the tears are not of the correct consistency and evaporate too quickly. For some people, it feels like a speck of sand in the eye, or stinging or burning that does not go away. For others, dry eye can become a painful chronic and progressive condition that leads to blurred vision or even vision loss if it goes untreated. Moderate-to-severe dry eye is associated with significant pain, role limitations, low vitality, poor general health, and often depression.
Dry eye as an important area of vision research funded by the National Eye Institute (NEI) within the National Institutes of Health (NIH). The NEI has issued a press release recognizing Dry Eye Awareness Month, addressing its research to better understand the causes of the disease and to develop treatments, as well as an updated fact sheet.
About the TFOS DEWS II™ Report and the Briefing
The July 2017 Dry Eye Awareness Month activities were especially poignant, due to the July 20 publication of the TFOS Dry Eye Workshop II™ Report (TFOS DEWS II™) in The Ocular Surface journal. In this first re-examination of the topic since the initial TFOS DEWS™ report issued in 2007, TFOS DEWS II™ updates the definition, classification, and diagnosis of dry eye; critically evaluates the epidemiology, pathophysiology, mechanism, and impact of the disease; addresses its management and therapy; and develops recommendations for the design of clinical trials to assess pharmaceutical interventions.
The Briefing faculty reflected experts engaged in development of the TFOS DEWS II™ Report. They highlighted that, although researchers have long known about age, sex, and gender as factors, they are now discovering ethnic and racial differences and the fact that dry eye impacts younger patients. Dry eye can have many causes, including environmental exposure; side-effects from medications; eye surgery (such as laser correction surgery); lid disorders; immune system diseases such as Sjögren’s Syndrome, lupus, or rheumatoid arthritis; contact lens wear; cosmetic use; aesthetic procedures; and an increasingly common cause—staring at computer or video screens for too long without blinking.
Speaker highlights include:
- Paul Karpecki, OD, FAAO (Director, Cornea Services, Kentucky Eye Institute), who served as moderator, began by asking attendees about the number of hours that they sleep, wear contact lenses, or work on a computer each day—noting that all are dry eye risk factors. He described dry eye’s impact on quality of life in graphic terms, stating that, “Imagine if every day you woke up and were aware of your eyes, like a broken windshield wiper on a car.”
- TFOS Founder David A. Sullivan, MS, PhD, FARVO (Senior Scientist, Schepens Eye Research Institute, and Associate Professor, Department of Ophthalmology, Harvard Medical School) addressed the pathophysiological mechanism of dry eye and how it may be induced unintentionally through medical treatment by a physician—called Iatrogenic Dry Eye—resulting from drug therapies, ophthalmic surgeries, and several other causes. He also addressed quality of life issues, noting that the impact of moderate-to-severe dry eye is comparable to dialysis and sever angina. He concluded by presenting the updated TFOS DEWS II™ Report definition of dry eye:
“Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.”
- Susan Vitale, PhD, MHS (National Eye Institute) described the work of the TFOS DEWS II™ Epidemiology Subcommittee in assessing the prevalence of dry eye and identifying risk factors. “Non-Modifiable” risk factors include age, female sex, Asian race, meibomian gland (oil glands in eyelids) dysfunction, connective tissue diseases, and Sjögren’s Syndrome. “Modifiable” risk factors include: androgen deficiency, computer use, contact lens wear, hematopoietic stem cell transplantation, environmental factors (pollution, low humidity, and sick building syndrome), and medications (antihistamines, antidepressants, anxiolytics, and isotretinoin).
- Janine Austin-Clayton, MD (NIH Associate Director for Research on Women’s Health and Director, Office of Research on Women’s Health, NIH) addressed dry eye implications for women. She acknowledged that sex differences in ocular diseases have been known since the 19th century, and that U.S. women are disproportionately affected by major eye conditions such as age-related macular degeneration, cataract, glaucoma, refractive errors, low vision, and blindness. Women have a higher prevalence of dry eye—often related to the greater incidence of autoimmune diseases, depression, and chronic pain—and use more treatments and therapies than men. Dry eye also affects their quality of life in ways different than men. She concluded by reminding attendees that their eyes are constantly making tears and that, “You only know that you are making tears all the time when your eyes are not making tears.”
TFOS Executive Director Amy Gallant Sullivan discusses the TFOS DEWS II™ Report’s publication in The Ocular Surface journal
Moderator Dr. Karpecki called on attendee Andrew Morgenstern, OD, FAAO (consultant to the joint Department of Defense/Department of Veterans Affairs Vision Center of Excellence) to respond to a question about the impact of dry eye on veterans. The VA reports that upwards of 70 percent of Traumatic Brain Injury (TBI)-exposed veterans have dry eye symptoms.
Susan Stone, JD (left) and Maria Zanardo (right), both from Allergan, with Ali Manson (American Optometric Association)
Steven Zhang, MD, PhD (Shire) with NAEVR Executive Director James Jorkasky
TearLab Conducts “Test Your Tears” Dry Eye Screening
Prior to and after the Briefing, Michael Berg and Benjamin Sullivan, PhD of TearLab conducted the “Test Your Tears” screening using the TearLab Osmolarity System, which measures osmolarity of human tears to aid in the diagnosis of dry eye disease, in conjunction with other methods of clinical evaluation. Osmolarity is an important biomarker of ocular surface health.
TearLab’s Michael Berg conducts a screening
The Briefing/Screening/Poster Session drew a capacity crowd in the Rayburn House Office Building’s Gold Room
Research Advocates Present Posters, Join Speakers in Congressional
Prior to and after the Briefing, four clinicians and researchers engaged in TFOS DEWSII™ Report development, each presented posters on different aspects of dry eye as follows:
- “Why Is the Tear Film Important?” Carolyn Begley, OD, MS, FAAO (Professor, Indiana University School of Optometry)
- “Why is Dry Eye Disease Painful?” Anat Galor, MD (Staff Physician, Surgical Services, Miami Veterans Administration Medical Center and Associate Professor of Clinical Ophthalmology, Bascom Palmer Eye Institute/University of Miami)
- “Why is Dry Eye a Problem for Doctors?” Victor Perez, MD (Professor of Ophthalmology, Microbiology, and Immunology, Bascom Palmer Eye Institute/University of Miami)
- “Can the Use of Cosmetics Affect Dry Eye?” Laura Periman, MD (Private Practice, Redmond Eye Clinic, Redmond, Washington)
Left to right: Kim O’Sullivan (Association of Schools and Colleges of Optometry) with
Left to right: Shefa Gordon, PhD (NEI) with
Left to right: Dr. Periman with a Congressional staff member
Left to right: Dr. Perez with Reza Haque,
MD, PhD (Shire)
TFOS Executive Director Amy Gallant Sullivan and Briefing Moderator Dr. Karpecki joined the research advocates in meetings with their Congressional delegations, joined by NAEVR’s James Jorkasky and David Epstein. While describing dry eye’s impact on quality of life and productivity, the advocates emphasized the importance of research into its causes and treatments which is supported by the NEI.
Senator Maria Cantwell (D-WA), left, with
Cong. Ileana Ros-Lehtinen (R-FL), center, with Dr. Galor and Dr. Perez
Dr. Karpecki, right, meets with Amy Nabozny, from the office of Senate Majority Leader Mitch McConnell (R-KY)
Amy Gallant Sullivan, center, with Nikki Hart and Jeremy D’Aloisio, from the office of Senator Edward Markey (D-MA)
Senator Todd Young (R-IN) with Dr. Begley
Congressional Recognition of Dry Eye Awareness Month
Senator Tammy Baldwin (D-WI)
Cong. Pete Sessions (R-TX)
The Congressional Record editions of July 12 and July 17 included Dry Eye Awareness Month recognition statements by Cong. Pete Sessions (R-TX) and Senator Tammy Baldwin (D-WI), respectively. In 2009, Cong. Sessions and then-Cong. Baldwin were co-sponsors of the successfully passed H. Res. 366, which recognized the NEI’s 40th anniversary and designated 2010-2020 as the “Decade of Vision.” Long-time advocates for the NEI and vision research, Cong. Sessions is Chair of the House Rules Committee and Senator Baldwin is a member of the Senate Labor, Health and Human Services, and Education (LHHS) Appropriations Subcommittee, with jurisdiction over NIH/NEI funding, and the Senate Health, Education, Labor & Pensions (HELP) Committee, which has oversight jurisdiction over NIH.
Vision community/coalition partners that supported Dry Eye Awareness Month educational activities include:
|Alliance for Eye and Vision Research
American Academy of
American Academy of Optometry
American Optometric Association
Association for Research in Vision
Research to Prevent Blindness|
Sjögren’s Syndrome Foundation
Tear Film & Ocular Surface Society
University of Alabama at Birmingham School
Women’s Eye Health
Women in Ophthalmology
TFOS thanks the following industry partners who supported TFOS DEWS II™ with unrestricted donations, including: Novartis Pharmaceuticals Corporation and Alcon, a division of Novartis, Shire, Allergan, Bausch+Lomb, Akorn, CooperVision, Dompé, Horus Pharma, Lµbris Biopharma, Oculeve, TearLab, Laboratoires Théa, SIFI, Johnson & Johnson Vision Care, Quint Health, Scope Ophthalmics, Sun Pharma, Carl Zeiss Meditec, Inc. ZEISS Group, and Senju.
AEVR thanks Shire for a grant to support the Briefing/Screening event management.