Expert Opinion in the Management of Aqueous Deficient Dry Eye Disease (DED)

Aileen Sy; Kieran S. O'Brien; Margaret P. Liu; Puja A. Cuddapah; Nisha R. Acharya; Thomas M. Lietman; Jennifer Rose-Nussbaumer


BMC Ophthalmol. 2015;15(133) 

In This Article


A survey was distributed to researchers and expert practitioners in the field of DED via the internet survey tool SurveyMonkey (, LLC; Palo Alto, California) in April 2013. Experts were identified by collecting corresponding author information from recently published manuscripts in the field of dry eye. PubMed and Web of Science were queried using the search terms "sjögren eye," "keratoconjunctivitis sicca," and "dry eye," and all articles published from November 2008 to November 2012 were included. Those who had previously opted out of receiving emails from SurveyMonkey or those with invalid email addresses were pre-determined to be ineligible. The survey was anonymous and no participant identifiers of name, gender or age were collected; all recipients had the option of participating or opting out. IRB exemption was obtained from the University of California, San Francisco Committee on Human Research. The study adhered to the Declaration of Helsinki and all federal and state laws. After its initial distribution in April 2013, two survey reminders were sent and the survey was closed on July 1, 2013.

The survey consisted of 11 questions (Appendix 1), which were developed after a literature search identified the most common available medications for DED. Survey recipients were first presented with a clinical scenario of a patient with symptoms and physical exam findings consistent with aqueous deficient DED. Respondents were then asked to describe their use of various therapies for this patient including punctal plugs, topical, and oral medications using Likert scales. Next, participants were asked to indicate which of these therapies they would be interested in using more and primary limitations to their current use. Respondents were questioned regarding their routine treatment algorithms and treatment milestones they use to guide therapy. Lastly, general demographic questions were asked. Descriptive statistical analyses were performed using Stata 10.0 (StataCorp, College Station, TX).