DEWSII

With the recent release of DEWSII (Dry Eye Workshop Report), many journals are publishing articles about the report and what it means to optometry and patient care. While DEWSII offers several new, valid recommendations, does it influence how many doctors practice?

Many optometrists are in search of a “cookbook” for ocular surface disease. While a perfect algorithm may be a fallacy, the DEWSII report does provide an easy-to-follow diagram for practitioners. The roadmap provided in the report begins with “patient presentation.”

Communication with the patient is often overlooked and one of the essential elements in compliance with a treatment plan and, ultimately, the annuity of the patient within the practice. Next, the first fork in the road is determined by the patient’s symptomatology (or lack there of). The asymptomatic patient may still show signs of dry eye.

The asymptomatic patient may still show signs of dry eye. The absence of complaint is not an absence of disease. Conversely, the presence of symptoms in the absence of objective signs does not mean that the patient is malingering. DEWSII uniquely addresses the sign and symptom discordance (also known as the dry eye “diagnostic mismatch”).

Beyond the acknowledgment of the discordance, the report provides a diagnostic and treatment guide. While it’s recommended that doctors read the report in its entirety, the well-crafted diagrams provide an ideal overview of the report.

They offer an introduction to what is more substantively located in the body of the work. The diagnostic flow charts are easy to interpret and follow. More importantly, a practitioner can use much of the information in day-to-day practice. While precision in diagnosis is somewhat dependent on a practice’s commitment to technology, doctors with few special dry eye tests can still benefit from the report.

DEWSII was long awaited by many in the dry eye community. While the report’s updated version may not be earth shattering to many, it does highlight areas of dry eye disease diagnosis and management that were not addressed in the prior rendering in 2007.

Many practitioners were woefully unaware of the significance of dry eye disease when the first edition was released and did not take to heart the impact that dry eye could have on contact lens tolerance, surgical outcomes and more. The heightened level of awareness among practitioners in 2017 and beyond will put DEWSII in the forefront of dry eye management.