Abstract

SO.04.01

Current classification of dry eye

Elisabeth M. Messmer
Ludwig-Maximilians-Universität, Klinikum Innenstadt, Augenklinik, München

The Dry Eye Workshop (DEWS) Report published in 2007 established a new definition and classification scheme for dry eye. The authors recommended a three-part classification system. The first classification is etiopathogenic and illustrated the multiple causes of dry eye. The second emphasizes the core mechanisms in dry eye, “tear film hyperosmolarity” and “tear film instability”, and their action in a vicious circle. The third classification scheme is based on severity of dry eye disease. According to the etiopathologic classification, dry eye patients roughly belong into one of two groups: patients with aqueous deficient dry eye and patients with evaporative dry eye, but both groups overlap significantly. Aqueous deficient dry eye has two major groupings, Sjogren’s syndrome dry eye and non-Sjogren syndrome dry eye including age related dry eye, lacrimal gland duct obstruction, reflex block and drug side effects. Evaporative dry eye may be caused by blepharitis, disorders of lid aperture and blink, contact lens wear, topical preservatives and ocular surface disease such as allergy. The classification according to dry eye severity is based on discomfort, severity and frequency of symptoms, visual symptoms, conjunctival injection and staining, corneal signs and staining, lid/meibomian gland signs, tear film break up time and Schirmer test values. These classification schemes for dry eye are helpful in clinical decision making and in the conduct of clinical research.

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