“The measure of success is not whether you have a tough problem to deal with, but whether it’s the same problem you had last year.” –John Foster Dulles

Ocular surface disease has been a passion and pursuit of mine for well over 20 years, with my early studies being specific to contact lens-related dry eye and my most recent ones focused on meibomian gland dysfunction. During this time, there have been numerous global workshops, consensus-based groups, regulatory insights, innovative diagnostics and therapeutics launched, and substantial scientific progress made. Yet, in many ways, dry eye diseases remain enigmatic.

Why? The detailed answer(s) could fill an entire issue of Contact Lens Spectrum! There are many etiologies of dry eye disease, leading to numerous classifications of the disease. The tear film is supported and produced by the ocular surface mucous membrane, but unlike most other mucous membranes in the human body (e.g., lungs), the ocular surface has the most direct exposure to the environment and its varied conditions. The tear film is incredibly complex in composition—more than 1,000 proteins, hundreds of lipid species, dozens of mucins, electrolytes, and water. It is also incredibly complex in function—lubrication, wetting, optical, antimicrobial, anti-evaporative, among others. And we still don’t know the many ways how the tear-secreting cells or glands are entirely regulated—whether that be through gene coding, neural modulation, or hormonal regulation.

There is no doubt that patient care has progressed in dry eye disease. The industry has been remarkable in advancing exciting technologies to help care for patients. So, while some questions from last year remain, I think we can be confident in knowing that progress is being made in addressing this major problem for our patients!

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The goal of Contact Lens Spectrum is to provide you with timely and thought-provoking articles that will help you become a more successful contact lens practitioner. Please let us know how we’re doing! E-mail CLSpectrum@pentavisionmedia.com with your comments or article submissions.