Events

Speakers Urge More Dry Eye Disease Research as Vision Community Recognizes Dry Eye Awareness Month 2018 with a Capitol Hill Briefing and Screening

Left to right: The Briefing faculty consisted of Scott Schachter, OD (Vision Source, Pismo Beach, California and Adjunct Clinical Professor, Marshall B. Ketchum University), Janine Austin-Clayton, MD (National Institutes of Health), Penny Asbell, MD (Professor of Ophthalmology/Icahn School of Medicine at Mt. Sinai), David A. Sullivan, MS, PhD, FARVO (Schepens Eye Research Institute/Harvard Medical School and Founder, Tear Film & Ocular Surface Society, TFOS), Leslie O’Dell, OD, FAAO (Wheatlyn Eye Care, York, Pennsylvania), Amy Gallant Sullivan, Executive Director, Tear Film & Ocular Surface Society, and James Jorkasky, AEVR Executive Director
Left to right: The Briefing faculty consisted of Scott Schachter, OD (Vision Source, Pismo Beach, California and Adjunct Clinical Professor, Marshall B. Ketchum University), Janine Austin-Clayton, MD (National Institutes of Health), Penny Asbell, MD (Professor of Ophthalmology/Icahn School of Medicine at Mt. Sinai), David A. Sullivan, MS, PhD, FARVO (Schepens Eye Research Institute/Harvard Medical School and Founder, Tear Film & Ocular Surface Society, TFOS), Leslie O’Dell, OD, FAAO (Wheatlyn Eye Care, York, Pennsylvania), Amy Gallant Sullivan, Executive Director, Tear Film & Ocular Surface Society, and James Jorkasky, AEVR Executive Director

On July 11, 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 2018 as Dry Eye Awareness Month—the second year of this re-formalized and expanded event that included a Congressional Briefing and “Test Your Tears” Dry Eye Screening, along with Congressional delegation visits managed by the National Alliance for Eye and Vision Research (NAEVR). The Briefing focused on the TFOS Dry Eye Workshop II™ Report (TFOS DEWS II™), published in The Ocular Surface journal in July 2017, and how it has impacted clinical practice and research. TFOS DEWS II™ was the first re-examination of the topic since the initial TFOS DEWS™ report issued in 2007, updating the definition, classification, and diagnosis of dry eye; critically evaluating the epidemiology, pathophysiology, mechanism, and impact of the disease; addressing its management and therapy; and developing recommendations for the design of clinical trials to assess pharmaceutical interventions.

About Dry Eye
TFOS Founder David A. Sullivan, MS, PhD, FARVO (Senior Scientist, Schepens Eye Research Institute, and Associate Professor, Department of Ophthalmology, Harvard Medical School) moderated a panel of four experts, several of whom were among the 150 experts from 23 countries who participated in the development of the TFOS DEWS II™ Report. Dr. Sullivan provided an overview, noting that Dry Eye Disease (DED) is one of the most frequent causes of patient visits to eye care providers and has a significant impact on healthcare policy as it affects more than 30 million Americans and costs the United States healthcare system $3.8 billion annually, with a $55.4 billion annual 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, dry eye feels like a speck of sand in the eye, or stinging or burning that does not go away. For others, it 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. There is no cure for DED—at best, eye care professionals manage the disease.

Although researchers have long known about age, sex, and gender as factors, they are now discovering ethnic and racial differences, and that dry eye impacts younger patients. Dry eye disease can have many causes, including environmental exposure; side-effects from medications; eye surgery; lid disorders; autoimmune 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 smartphone screens for too long without blinking. Iatrogenic dry eye— or that induced by drugs, medical devices, or medical procedures—is a growing global problem.

DED and Comorbidities
Since dry eye is an important area of vision research funded by the National Institutes of Health (NIH), especially its National Eye Institute (NEI), Janine Austin-Clayton, MD (NIH Associate Director for Research on Women’s Health and Director, Office of Research on Women’s Health, NIH) addressed more fully the causes and comorbidities of DED —including autoimmune diseases, thyroid disease (especially Graves’ disease), diabetes, Graft versus Host disease (after a bone marrow transplant), viral infections (such as Human Immunodeficiency Virus and Epstein-Barr virus) and blepharitis (eyelid inflammation). She emphasized that two-thirds of those with DED are women, in part due to the greater incidence of autoimmune diseases.

DED and Contact Lenses
Clinician-Scientist Penny Asbell, MD (Professor of Ophthalmology/Icahn School of Medicine at Mt. Sinai) reported that, while contact lens wearers are more likely to have symptoms of DED, research is needed as to whether contact lenses cause dry eyes or does underlying DED lead to contact lens discomfort. Regarding the latter, she described the potential role that meibomian gland dysfunction (MGD) may play. These exocrine glands at the rim of the eyelids supply meibum, the oily substance that prevents evaporation of the eye’s tear film, and when not functioning properly may result in alteration of the tear film, symptoms of eye irritation, inflammation, and ocular surface disease.

DED and Cosmetics Use
Leslie O’Dell, OD, FAAO (Wheatlyn Eye Care, York, Pennsylvania) spoke about the use of cosmetics and the incidence of ocular surface disease (OSD)/DED. She reported that the average woman exposes herself to 167 different chemicals on her body and face during her daily regimen. There are ingredients in commonly used eye makeup and beauty products that can exacerbate dry eye symptoms by affecting how the meibomian glands function and lubricate the tear film, increasing the inflammation-inducing evaporative load of patients with OSD. She also recognized that cosmetics include carcinogens, endocrine disruptors, neurotoxins, and reproductive toxins—many of which are banned in the European Union but not in the United States. This has resulted in Congressional proposals to update the Federal Food, Drug, and Cosmetic Act to require manufacturers to register ingredients of personal care products and any adverse reactions with the Food and Drug Administration (FDA).

DED and Digital Device Use
Scott Schachter, OD (Vision Source, Pismo Beach, California and Adjunct Clinical Professor, Marshall B. Ketchum University) spoke about the increasingly common relationship between digital eye strain and DED. He presented numerous statistics about digital device use—including that 83 percent of Americans use digital devices for more than two hours per day and that 60 percent report experiencing symptoms of digital eye strain. He noted that the quality of blinks and their frequency diminishes when viewing a digital device versus hard copy, which promotes DED. He concluded by reporting that, by three years of age, 68 percent of children regularly use a digital device, resulting in an amplified population of younger patients affected by dry eye.

Commenting on the day, Mr. Jorkasky said, “The Dry Eye Awareness Month events are accomplishing what AEVR and TFOS intended—educating policymakers about the need for more research into DED, especially as to how numerous factors, including everyday lifestyle/activity decisions, are resulting in a dramatic increase in disease incidence.”

  AEVR Executive Director James Jorkasky with Steven Zhang, MD, PhD (Shire)
AEVR Executive Director James Jorkasky with Steven Zhang, MD, PhD (Shire)
Michael Duenas, OD and Ali Manson, both from the American Optometric Association
Michael Duenas, OD and Ali Manson, both from the American Optometric Association

TearLab Conducts “Test Your Tears” Dry Eye Screening
Prior to and after the Briefing, Benjamin D. Sullivan, PhD 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 Chief Scientific Officer Benjamin Sullivan, PhD, conducts a screening
TearLab’s Chief Scientific Officer Benjamin Sullivan, PhD, conducts a screening

 

Briefing Faculty Educates Congressional Delegations
Under the auspices of NAEVR, the Congressional Briefing speakers visited their Congressional delegation offices to describe their DED clinical practice and research, as well as the overall importance of robust research funding at the NIH/NEI.

 

Cong. Salud Carbajal (D-CA) with Dr. Schachter
Cong. Salud Carbajal (D-CA) with
Dr. Schachter
Dr. O’Dell with Corey Ensslin, office of Senator Pat Toomey (R-PA)
Dr. O’Dell with Corey Ensslin, office of Senator Pat Toomey (R-PA)
Jasmin Palomares, office of Senator Kirsten Gillibrand (D-NY) with Dr. Asbell
Jasmin Palomares, office of Senator Kirsten Gillibrand (D-NY) with Dr. Asbell
From left: Dr. Sullivan, Brianna Battle, office of Senator Ed Markey (D-MA) and Ms. Gallant Sullivan
From left: Dr. Sullivan, Brianna Battle, office of Senator Ed Markey (D-MA) and Ms. Gallant Sullivan

Vision community/coalition partners that supported Dry Eye Awareness Month 2018 educational activities include:

American Academy of Ophthalmology
American Academy of Optometry
American Optometric Association
Association for Research in Vision and Ophthalmology
Prevent Blindness
Research to Prevent Blindness

AEVR thanks Shire for a grant to support the Briefing/Screening event management.

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, Quint Health, Scope Ophthalmics, Sun Pharma, Carl Zeiss Meditec, Inc. ZEISS Group, and Senju.