dry eye dx and tx

New Society Focuses on Ocular Surface Disease

BY JACK L. SCHAEFFER, OD

Is there a need for another society, especially one dedicated to the ocular surface? By the end of this article, the executive committee and the 55 charter members of the Ocular Surface Society of Optometry (OSSO) hope that you will answer yes.

The Importance of OSD Exams

One of the greatest advances in eye care over the last five years is the recognition of the importance of ocular surface disease (OSD). OSD encompasses many entities that should be diagnosed and managed in our clinics every day. Dry eye, meibomian gland disease, anterior blepharitis, epithelial basement membrane dystrophy, keratitis, conjunctivitis, corneal dystrophy, and more are encompassed by this entity.

In the same period we've seen a new entity emerge: lid wiper epitheliopathy. When Korb et al (2002) identified this new entity, they discovered another cause of ocular discomfort with a new treatment regimen.

What also has changed in recent years is that we now recognize the multifactoral causes that lead to ocular surface disease and associated patient discomfort.

How do we treat the disease and, most importantly, how do we improve our patients' quality of life?

Many practitioners perform refractive or comprehensive exams and dispense artificial tears or a prescription to patients. But to understand a patient's ocular surface, a complete OSD evaluation is imperative and should be an integral part of any treatment regimen. Gaining an understanding of each patient's ocular condition requires an OSD exam that includes protocols and procedures to determine the cause of the disease. Our goal as practitioners should be not only to treat disease, but also to prevent it.

Keeping up With Research

Almost every eyecare publication today has articles pertaining to meibomian gland disease (MGD). These articles cover topics such as meibum expression, new drugs, and examination techniques. We are also seeing an increase in off-label usage of therapeutics based on clinical observations. The OSD arena is moving so fast that treatment protocols are being established through clinical observations faster than research can present evidence-based medicine.

The latest research has discovered many new examination techniques, medications, treatment modalities, and patient educational needs, and we as practitioners need a more streamlined way to access this information. The Ocular Surface Society of Optometry has been in the works for more than two years and has finally emerged as an organization established for the enhancement of knowledge about OSD.

OSSO will disseminate all of the latest evidence-based medicine, current lecture materials, and clinical case studies in an interactive Web page as an educational forum. This new society will also serve as a forum for industry to communicate any new or important information about their products, both pharmaceuticals and equipment. Our goal is to enlist the greatest minds in our field working in clinical practice and research. We are proud of the involvement of optometry with the world leaders in researching the changes in OSD.

Fulfilling a Need

We ask you again—do we need a new society? The answer is absolutely. If you are interested in joining or in learning more about OSSO, please visit www.ossopt.com. CLS

For references, please visit www.clspectrum.com/references.asp and click on document #172.

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Dr. Schaeffer practices in Birmingham, Ala., where he is also president of a 12-location group practice and a refractive laser center. He lectures internationally, serves on many industry boards and advisory panels, and is involved with many clinical studies on contact lenses, pharmaceuticals, and equipment. He is current president of the Ocular Surface Society of Optometry.