Dry Eye Disease Management in Portugal - Online Survey Results

Abstract

Introduction: With growing prevalence, reduced quality of life, significant socioeconomic burden and a definite impact in cataract and laser vision correction surgeries, dry eye disease (DED) is currently a hot topic in ophthalmology. In recent years, several guidelines have been carried out to standardize the diagnosis and improve treatment approach. We intend to characterize current practices in Portugal, identify opportunities for improvement and delineate strategies to address them. Material and Methods: Cross-sectional online survey designed to assess the diagnostic approach and treatment of DED and made available to ophthalmologists across the country. The survey included 5 questions on ophthalmological profile of participants, 4 questions on DED diagnosis and 3 questions on DED treatment. Statistical analysis was made using SPSS version 26. Results and Discussion: One hundred twenty two ophthalmologists answered the survey (about 10% of practitioners in Portugal). A percentage of 48% observe between 20-40 patients with DED per month. A total of 67% always examine ocular surface of laser vision correction candi- dates, whereas only 30% always do it for cataract surgery patients. The most frequently identified DED symptom is foreign body sensation. The most commonly used diagnostic methods are fluo- rescein staining and tear break up time. Regarding treatment modalities, almost 50% of participants never used lacrimal plugs and very few recommended contact lenses or autologous serum. Mild DED treatment is considered to be very effective by 80% of ophthalmologists, while in severe DED by only 0.01%. 36% believe available treatment options are ineffective in severe DED. Conclusion: DED represents a high volume of patients seen in ophthalmology clinics. Our results mimic others in Europe and the United States. Overall, diagnosis and treatment practice patterns are in agreement with the current recommendations. However, there is still room for improvement. All patient prior surgery should be examined for DED, symptoms should be considered more as part of diagnosis and follow-up, and some easily available treatment options should be considered more often. Our findings also highlight the concern with treatment in severe DED, in which more effective therapies are needed.