Dry Eye 2020

DRY EYE 2020
OSL: Ocular surface changes over time
By Bhavna Patel
DRY EYE DISEASE (DED) affects
approximately one in three New Zealanders.
As clinicians, it’s critical that we accurately
diagnose and manage this impactful disease.
Left untreated, DED is detrimental to patients’
quality of life with its impact ranging from
intermittent ocular discomfort to more serious
psychological effects, such as depression.
The TFOS DEWS II report improved
our understanding of DED and identified
knowledge gaps, prompting further research.
For example, we now know that most patients
suffer from an evaporative form of dry eye
and that the disease is perpetuated by entering
a vicious cycle of worsening clinical signs
and symptoms over time. However, our
understanding of the early, or preceding stages
of this cycle, is still relatively limited.
Research from the University of Auckland’s
Ocular Surface Laboratory (OSL) has
significantly advanced our knowledge about the
natural history of dry eye disease, identifying
the order and progression of ocular surface
changes¹ , ². Meibomian gland morphological
features identified in paediatric populations
in this research, indicate an earlier disease
onset than previously thought. To facilitate
better management and prevention strategies
in future, we must seek to improve our
understanding of the onset and evolution of
DED as well as the key risk factors.
For my masters’ project, I will be
undertaking a longitudinal, long-term study of
tear film and ocular surface changes in a cohort
of young participants. Annual assessments
of university students will be conducted and
will include the evaluation of lifestyle factors,
such as diet and screen time, ocular symptoms,
as well as anterior segment assessments. By
identifying the progression of ocular changes
over time, this study is expected to complement
our understanding of the natural history of
DED and contribute to our ability to detect risk
factors earlier.
References
1. Wang MTM, Craig JP. Natural history of dry eye disease: Perspectives
from inter-ethnic comparison studies. Ocul Surf 2019; 1–10.
2. Craig JP, Wang MTM, Muntz A, Lim J, Kim JS et al. Ageing and the
natural history of dry eye disease: a prospective registry-based crosssectional
study. Ocul Surf 2020; in press.
Bhavna Patel is a professional teaching fellow in
the School of Optometry and Vision Science and
part-time MSc student with the OSL at the University
of Auckland.
BCLA dry eye certificate downunder
FOR THE FIRST time, the British Contact Lens
Association’s (BCLA’s) Certificate in Dry Eye and
Contact Lens Retention, will be available
outside of the UK.
The Tear Film and Ocular Surface
Society’s second dry eye workshop
(TFOS DEWS II) vice chair,
Associate Professor Jennifer Craig,
has been approved to lead the first
satellite objective structured clinical
examinations (OSCE) testing site outside
the UK in New Zealand.
Recognised as a game-changer in continuing
education, the BCLA was the first to bring its members
live demonstration TFOS DEWS II lectures in 2017. These now
feature across the world, including within the University of Auckland’s
School of Optometry and Vision Science (SOVS) teaching programme.
Together with fellow TFOS DEWS II steering committee members,
Professors James Wolffsohn and Lyndon Jones, A/Prof Craig (collectively
nicknamed the ‘three musketears’), subsequently joined forces with the
BCLA to develop the dry eye disease (DED) management certificate.
It can be used towards a BCLA fellowship and is designed to support
practitioners’ keen to specialise in DED management.
Comprised of a series of online lectures and
resources, with online assessment and
feedback, it also includes approved
practical workshops for gaining handson
experience in performing the latest
techniques.
“Having the certificate signals
to patients and peers alike, a
practitioner’s dedication and high level
of contemporary knowledge in dry eye,
which can facilitate practice-building in this
specialist area,” said A/Prof Craig, adding how
exciting it is to bring the certificate to practitioners in
Australasia for the first time.
The first New Zealand OSCE, scheduled to be held in parallel with
the SOVS-hosted Scientific and Educators’ Meeting in Optometry
(SEMO) conference in April, fell victim to the impact of the pandemic,
but is expected to be up and running in coming months, said A/
Prof Craig. Those interested in BCLA membership and pursuing a
Certificate in Dry Eye and Contact Lens Retention are encouraged to
check the BCLA website (www.bcla.org.uk) for more details.
16 | NEW ZEALAND OPTICS SEPTEMBER 2020