To examine clinical management and prescribing patterns for dry eye disease (DED), in relation to severity and subtype, by eyecare practitioners across the globe.
An online-anonymous cross-sectional survey (on Qualtrix) translated into 14 languages was distributed to eyecare practitioners across the globe. The survey included six questions around the management of DED, in relation to severity and subtype.
The survey was completed by 1139 eyecare professionals (37% ophthalmologists and 58% optometrists) from 51 countries. Management varied significantly by continent and country (p < 0.01). The most commonly recommended management approaches internationally, included general advice (87%), low (85%) and high (80%) viscosity-enhancing unpreserved lubricants and lid wipes/scrubs (81%). Some treatments were prescribed largely independent of severity (e.g. artificial tears and nutritional supplements) while oral antibiotics, punctal occlusion, topical anti-inflammatory/immunosuppressants, secretagogues, biologics, therapeutic contact lenses and surgical approaches were prescribed by more practitioners as severity increased. Essential fatty acids, lipid sprays/drops, lid hygiene, warm compresses, intense pulsed light therapy and antibiotics (topical or oral) were more commonly recommended for evaporative DED, while artificial tears, moisture chamber goggles, punctal occlusion, therapeutic contact lenses, secretagogues and biologics were used more commonly for aqueous deficient DED.
DED management differs between continents and countries. A wide range of management strategies are utilised at each severity level and across subtypes. The survey results enable clinicians to benchmark their practice to their peers, indicate where further research is required to optimise patient management and to inform industry on how best to target product development.

Copyright © 2021. Published by Elsevier Inc.

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