Background: Dry Eye (DE) sounds like a simple, easily treatable condition. In fact, DE is a complex, multifactorial disease that can cause severe pain, mental distress, suicidal ideation, and suicide. There are two DE variants: aqueous deficient (prevalence 20%) and evaporative (85%, usually Meibomian gland dysfunction (MGD)). Both often coexist. Although affecting some 35% of the population, DE is not well understood by patients and the medical community. The American Academy of Ophthalmology does not recognize DE as a specialty. As a result, both in research and clinical settings diagnostic and treatment protocols tend to be nonspecific, ad hoc, and inadequate, with a narrow industry-driven focus that largely ignores patients' actual symptoms and their etiology and other common ocular surface comorbidities.
Although some attempts have been made to solicit input from DE patients on outcomes important to them, patient input from the outset of clinical studies has been lacking, skewing results significantly toward industry-focused outcomes. Furthermore, comparative clinical effectiveness research (CER) on DE and MGD has been meager.
Proposed Solution to the Problem: The proposed solution brings together a diverse group of stakeholders who will identify gaps and opportunities in CER on DE diagnostic and treatment approaches in clinical practice and compile these into a comprehensive CER Roadmap for DE and MGD. The convened body of stakeholders will aim toward establishing a cohesive and comprehensive patient-centered approach to diagnosing and treating DE and comorbidities.
Objectives: The overall objective is to improve the landscape of DE for patients and establish a comprehensive patient-centered approach to treating and diagnosing DE and comorbidities.
Activities: From their personal experience with the disease and professional perspectives, the project team members will review the current DE research landscape, brainstorm to identify gaps and opportunities, and prioritize their findings in a CER roadmap that will inform future directions in DE research. The roadmap will be developed into a manuscript suitable for publishing in a peer-reviewed ophthalmology journal.
Projected Outcomes and Outputs: The roadmap will be used to inform research efforts at universities, medical centers, and the commercial DE industry, shifting research toward a focus on patients and patient-centered outcomes.
Patient and Stakeholder Engagement Plan: Patients and other stakeholders will be fully engaged in every step of the project.
- The project team represents the following groups: patients, patient advocates, caregivers, medical doctors, other clinicians, health care administrators, medical researchers, and health IT.
- All stakeholders will actively participate and collaborate in each general session and breakout session.
- Breakout groups will include a mix of patients and other stakeholders to ensure a variety of viewpoints are offered.
- All stakeholders will participate in the development and review of the roadmap and manuscript submitted for publication in a peer-reviewed ophthalmology journal.
Project Collaborators: The following organizations are represented by members of the project team: Not A Dry Eye Foundation; Univ. of Central Fla., Department of Health Informatics; Ocular Surface Research and Education Foundation; Dry Eye and Cornea Treatment Center; Univ. of South Fla., Department of Public Health.