I think we can safely say that dry eye disease is no longer considered by any practitioner as a single disease entity which can be addressed with a single drop. Indeed, if it were needed, the latest TFOS DEWS2 reports have emphasised that the condition has a wide variety of causes, both external and internal, and expresses itself in a range of ways, from corneal staining and tear break up time reduction through to tear osmolarity changes and fluctuations in inflammatory markers within the tears.
The condition itself may be of an evaporative or aqueous deficient nature, and usually a combination of the two in a ratio that might be anywhere along a spectrum of combinations of the two. Furthermore, the condition may have significant numbers of signs with few symptoms and vice versa.
No wonder, then, in order to provide an effective management plan, which is likely to involve a number of components to tackle the problem, it is necessary to carry out a range of assessments, to look at each result as part of an overall profile, and then to decide on the best remedial approach.
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