Cause Of Dry Eye Research Articles

Closing Eyes with Artificial Tears: A Simple and Effective Strategy to Combat Screen-Related Asthenopia and Dry Eye Symptoms

BackgroundThe widespread use of various video display terminals (VDTs) always had a detrimental impact on ocular health. Prolonged use of smartphones has been one of the leading causes of dry eye (DE) and asthenopia. Therefore, the purpose of this study is to find a simple and effective strategy to combat screen-related DE and asthenopia. MethodsA group of healthy participants aged 18 and above were randomly assigned to three groups and tasked with a 2-hour smartphone reading task. After 1 hour of usage, each group adopted different methods of rest: no rest (Group A), a 10-minute eye-closed rest (Group B), or a 10-minute eye-closed joint artificial tears rest (Group C). Ophthalmological examinations and questionnaires were administered to all participants before and after the 2-hour reading task. Results90 qualified volunteers, including 29 males and 61 females, were randomly assigned to three groups. Group A demonstrated a significant increase in the severity of DE and asthenopia as evidenced by all the evaluated indices. On the other hand, Group C did not exhibit any notable change in DE and asthenopia symptoms, with an improvement in corneal fluorescein staining (CFS) results (p > 0.05) when compared to the pre-reading values. Group B showed a significant increase in ocular surface disease index (OSDI) (p ≤ 0.05) and a decrease in critical flicker frequency (CFF) (p ≤ 0.05). ConclusionsClose-eye rest with artificial tears may be a convenient and effective prevention strategy for screen-related DE and asthenopia.

Prevalence of meibomian gland dysfunction at a tertiary centre in Taiwan

ABSTRACT Clinical relevance Meibomian gland dysfunction and dry eye disease are closely related conditions that often coexist and can contribute to the development of each other. Understanding the similarities and differences between these diseases can assist clinicians in implementing effective treatments for both conditions in a clinical setting. Background Dry eye disease is a multifactorial disease of the tears and ocular surface. This study aimed to evaluate the demographic characteristics of patients with meibomian gland dysfunction in Taiwan, investigate the association between meibomian gland dysfunction and dry eye parameters, and estimate the prevalence of meibomian gland dysfunction among patients with dry eye symptoms at a tertiary referral centre. Methods This cross-sectional study enrolled patients aged ≥20 years who complained of dry eye symptoms and visited a tertiary centre between September 2019 and March 2020. The patients completed the Ocular Surface Disease Index and Standard Patient Evaluation of Eye Dryness questionnaires before undergoing ocular examination. The lipid layer thickness and meiboscale scores were recorded. In addition, the study measured tear film break-up time, examined corneal staining, and evaluated the number of meibomian glands yielding liquid secretions using a slit lamp. Results The study evaluated 202 eyes of 202 patients with a mean age of 58.05 ± 13.34 years. The prevalence of meibomian gland dysfunction was 93%. Mean meiboscale score and age were negatively associated, and tear film break-up time was positively associated with the mean number of meibomian glands yielding liquid secretions. Hyperlipidaemia and smoking were the main risk factors for Meibomian gland dysfunction. Conclusions The prevalence of meibomian gland dysfunction among patients with dry eye symptoms was extremely high at the tertiary centre, highlighting the strong relationship between Meibomian gland dysfunction and dry eye disease. Clinicians should consider meibomian gland dysfunction as a possible cause of dry eye.

The role of Meibomian glands on the development of dry eye disease in patients with unilateral pseudoexfoliation

To evaluate the Meibomian glands and presence of dry eye in patients with unilateral pseudoexfoliation. The study included 32 patients with clinical pseudoexfoliation (PEX) in one eye and 30 controls. Schirmer and tear film break-up time (TBUT) tests were performed, along with a detailed ophthalmological examination, meibography and evaluation of areas of meibomian gland loss. Subjective symptoms were evaluated using the ocular surface disease index (OSDI). Schirmer test results for eyes with or without PEX were similar (10.438±4.47mm and 11.563±4.35mm, respectively), vs. 15.967±9.75mm in the control group. While measurements of TBUT were found to be similar in both eyes of the patient group (6.188±2.66s in eyes with PEX and 6.250±1.87s in eyes without PEX), this was 8.233±2.66s in the control group. Schirmer and TBUT test results were found to be significantly lower in both eyes of patients with unilateral pseudoexfoliation compared to control eyes. The rate of meibomian gland loss in the upper and lower eyelids in the patient group was found to be significantly higher than in the control group. Similarly, meiboscores of both eyelids in the control group were significantly lower than those in patient group; however, there were no differences between patient eyes with or without pseudoexfoliation. The patients with unilateral pseudoexfoliation had a significant loss of meibomian gland area in both eyes compared to the control group, and their meiboscore was higher. It should be considered that meibomian gland loss may be one of the causes of dry eye in patients with pseudoexfoliation.

The role of meibomian gland dysfunction on the development of dry eye disease in patients with facial nerve palsy.

To investigate whether meibomian gland dysfunction is the cause of dry eye in facial nerve palsy and to identify the possible relationship between the grades and durations of facial nerve palsy and meibomian gland dysfunction. This prospective observational study included 63 patients with unilateral facial nerve palsy. Facial nerve function and severity were assessed using the House-Brackmann grading system. Unaffected contralateral eyes were used as the control group. The following parameters were compared: tear breakup time, Schirmer 1 test score, area and density scores for corneal fluorescein staining, eyelid abnormality, meibomian gland expression, meibography scores, and areas of meibomian gland loss. A Pearson correlation analysis was performed between the grades and durations of facial nerve palsy and meibomian gland dysfunction. The eyes affected by facial nerve palsy demonstrated significantly lower tear breakup time (p<0.001) and significantly higher values for corneal fluorescein staining (p<0.001), Schirmer 1 test score (p=0.042), lid abnormality score (p<0.05), meibomian gland expression level (p=0.005), meibography scores (p<0.05), and areas of meibomian gland loss (p<0.05). The grade and duration of facial nerve palsy significantly correlated with meibomian gland dysfunction (p<0.05). Meibomian gland dysfunction has a significant contribution to the development of dry eye disease after facial nerve palsy. Furthermore, a strong correlation was observed between the grades and durations of facial nerve palsy and meibomian gland dysfunction.

Occurrence of dry eye in mobile phone users

Background: Most Indians today own one or more mobile phones. The average time of phone usage per person per day is 4.8 h and the excess usage of mobile phone is an emerging cause of dry eye. Although many studies have established this relation, not many studies focus on South India. Our study aims to highlight the South Indian population. Aim and Objective: The aim of the study was to study the prevalence of dry eye among medical students of 18–25 years. Materials and Methods: This is a cross-sectional study, whose participants are undergraduate medical students, both males and females, between 18 and 25 years. Schirmer’s test was done for each candidate after answering an Ocular Surface Disease Index questionnaire. Results: The most frequent symptom reported by the participants at the time of answering the questionnaire was soreness and irritation of the eye (8%). The most common long-term symptom reported was burning and watering of eyes of tolerable severity (27%). Some participants experienced uncomfortable and bothersome eye fatigue. Conclusion: Dry eye in the form of symptoms of both dryness of eye and reflex epiphora is present in the population under study. About 76% of the study population use their phones for over 3 h a day. The soreness and irritation of eyes, watering and burning of eyes are attributed to the mobile phone usage for more than 6 h per day.

Imaging the tarsal plate: A Mini-Review

Imaging the tarsal plate and the meibomian glands (MG) grants new opportunities for ophthalmic practitioners who work in the field of the ocular surface and dry eye across the globe. The secretory role of MG plays a fundamental part in protecting the moisture in front of the eye surface by creating an active shield made of meibum (lipid) which prevents tear evaporation and causes dry eye. Evidence from the most popular Dry Eye Workshop reports (2007 and 2016) demonstrate that MG dysfunction is the first cause of evaporative dry eye which is also the most common cause of dry eye and ocular surface discomfort. Fortunately, during the last years, a plethora of new devices for MG observation, diagnosis and follow-up have been made available in the market. These devices range from invasive to minimally invasive, high to low-tech and from being expensive to low-cost. The objective of this mini-review is to condense the latest evidence in MG imaging by providing a narrative overview on the most common technologies plus some other newer aspects which might guide clinicians and researchers in the field of the ocular surface and dry eye.

Chinese expert consensus on dry eye: dry eye related to immunologic diseases (2021)

Immunologic diseases is one of the important causes of dry eye. Dry eye related to immunological diseases, with more severe symptoms and signs and even vision loss, has complicated pathogenesis and is difficult to be diagnosed and treated. Thus, in order to improve the awareness among ophthalmologists, experts from the Chinese Branch of the Asian Dry Eye Society and other related academic organizations have conducted indepth discussions on the dry eye related to immunologic diseases, in terms of its definition, pathogenesis, clinical characteristics, diagnosis and treatment based on the clinical experience and related researches in this field in our country as well as international research progress, to form expert consensus opinions for reference in clinical work. This consensus further standardizes and promotes the diagnosis and treatment of dry eye related to immunologic diseases in China. (Chin J Ophthalmol, 2021, 57: 898-907).

Tear metabolomics highlights new potential biomarkers for differentiating between Sjögren's syndrome and other causes of dry eye

PurposeThe lacrimal exocrinopathy of primary Sjögren's syndrome (pSS) is one of the main causes of severe dry eye syndrome and a burden for patients. Early recognition and treatment could prevent irreversible damage to lacrimal glands. The aim of this study was to find biomarkers in tears, using metabolomics and data mining approaches, in patients with newly-diagnosed pSS compared to other causes of dry eye syndrome. MethodsA prospective cohort of 40 pSS and 40 non-pSS Sicca patients with dryness was explored through a standardized targeted metabolomic approach using liquid chromatography coupled with mass spectrometry. A metabolomic signature predictive of the pSS status was sought out using linear (logistic regression with elastic-net regularization) and non-linear (random forests) machine learning architectures, after splitting the studied population into training, validation and test sets. ResultsAmong the 104 metabolites accurately measured in tears, we identified a discriminant signature composed of nine metabolites (two amino acids: serine, aspartate; one biogenic amine: dopamine; six lipids: Lysophosphatidylcholine C16:1, C18:1, C18:2, sphingomyelin C16:0 and C22:3, and the phoshatidylcholine diacyl PCaa C42:4), with robust performances (ROC-AUC = 0.83) for predicting the pSS status. Adjustment for age, sex and anti-SSA antibodies did not disrupt the link between the metabolomic signature and the pSS status. The non-lipidic components also remained specific for pSS regardless of the dryness severity. ConclusionOur results reveal a metabolomic signature for tears that distinguishes pSS from other dry eye syndromes and further highlight nine key metabolites of potential interest for early diagnosis and therapeutics of pSS.

Influence of Face Masks on the Use of Contact Lenses.

Background: The COVID-19 epidemic is largely controlled by the use of face masks. The use of a face mask has been indicated as a strong cause of dry eye, although it is not yet described in the literature. This study aims to compare the impact of the use of masks on the visual quality of patients. The symptoms in the human eye intensified during the pandemic versus the symptoms before the pandemic, in a Portuguese population. Methods: A fifteen-question questionnaire was conducted to find out what changes occurred in the use of soft contact lenses during the pandemic in relation to the use of masks. Statistical analysis was performed with SPSS 27.0 software (SPSS Inc., Chicago, IL, USA). Results: The use of contact lenses decreased compared with before the pandemic (p < 0.001). The number of hours of wear decreased significantly compared with before the pandemic (p < 0.001). The sensation of dry eyes was found to be worse in those using monthly replacement contact lenses (p = 0.034), and the need to remove contact lenses was more frequent in women (p = 0.026) after using a mask. Conclusions: Mask use increases dry eye symptoms in contact lens wearers, negatively impacting visual quality.

Meibomian gland dysfunction is suppressed via selective inhibition of immune responses by topical LFA-1/ICAM antagonism with lifitegrast in the allergic eye disease (AED) model

PurposeThe etiology of meibomian gland dysfunction (MGD) is incompletely understood, despite being a common ophthalmic condition and an area of unmet medical need. It is characterized by an insufficiency in glandular provision of specialized lipids (meibum) to the tear film and is a major cause of dry eye. Work in the allergic eye disease (AED) mouse model has revealed an immunopathogenic role in MGD causation, now raising interest in the applicability of immunomodulatory therapies. As such, we herein ask whether inhibition of lymphocyte function associated antigen (LFA)-1/intracellular adhesion molecules (ICAM)-1 signaling via topical lifitegrast administration has a therapeutic effect on MGD in AED mice. MethodsMice were induced with AED by i.p. injection of ovalbumin (OVA) mixed with alum and pertussis toxin, followed 2 weeks later by once daily topical OVA challenges for 7 days. Mice were treated topically with 5% lifitegrast ophthalmic solution or vehicle (PBS) 30 min prior to challenge. We developed a clinical ranking method to assess MGD severity, and also scored clinical allergy. Conjunctivae and draining lymph nodes were collected for flow cytometry. ResultsTopical lifitegrast significantly inhibited clinical MGD severity, which was associated with diminished pathogenic TH17 cell and neutrophil numbers in the conjunctiva. No significant change in conjunctival TH2 cells or eosinophils, and only marginal differences in ocular allergy were observed. ConclusionsIn AED mice, lifitegrast inhibited MGD severity marked by a reduction in select immune populations in the conjunctiva. Our findings warrant future examination of lifitegrast in the treatment of patients with forms of MGD.

Effects of taking pregabalin (Lyrica) on the severity of dry eye, corneal sensitivity and pain after laser epithelial keratomileusis surgery

BackgroundCorneal nerve damage after laser epithelial keratomileusis (LASEK) is thought to be the cause of dry eye and pain. Therefore, we investigated whether taking pregabalin (Lyrica), which reduces peripheral neuropathic...

A STUDY ON LITERATURE REVIEW OF DRY EYE SYNDROME IN AYURVEDA W.R.T. SHUSHKAKSHIPAKA

Dry eye is a common ocular disease with a wide variety of symptoms due to multifactoral and elusive etiology. With a global prevalence ranging from 20 to 50%, dry eye disease (DED) is a significantly growing health problem worldwide. When symptoms of dry eye are analyzed, the disease that have striking similarity to dry eye, is Shuskakshipaka described by Acharyas Vagbhata and Sushruta in Sarvagat Netraroga. The commonest ocular symptoms are feeling of dryness, grittiness, foreign body sensation, itching, redness, photophobia, burning and pricking pain which gradually worsen over the course of day. Stringy discharge, transient blurring vision and crusting of lids are also common. Eventually symptoms worsen the condition of ocular surface and causes erosion and inflammation of lids, conjunctiva and cornea. Symptoms are timely relieved with the help of lubricating eye drops. In Ayurveda local treatment therapies like Ashchyotan, Parishek, Tarpan etc are performed. If not treated timely, there may be vision threatening complications, epithelial breakdown, ulceration, bacterial keratitis, trichiasis, keratinization, symblepheron, corneal perforation and melting. In recent times focus on treating the underlying cause of dry eye instead of conventional local treatments for symptomatic relief is highly considered by researchers studying xero-dacryology. In light of above knowledge, the present article focuses on evaluation of risk factors contributing to dry eye, pathophysiology and management of dry eye syndrome in terms of ayurveda.

Effect of Particulate Matter on the Tear Film in Contact Lens Wearers

Purpose : To investigate the influence of particulate matter (PM) on tear film in contact lens (CL) wearers, the tear volume and stability were evaluated according to the level of PM. Methods : Thirty-one myopes in their 20s wearing glasses and CL were participated, and they were required to wear soft CL (L brand, 55% water content) for 8 hours a day. The subjects were divided into the normal and dry eye groups according to the OSDI score. The levels of PM were divided good (0~30 ㎍/m³) and bad (51~100 ㎍/m³) according to the criteria provided by the Korea Environment Corporation. The tear tests were conducted both on the good and bad PM days. Tear volume was evaluated by OCCUTUBE and the stability was evaluated by TBUT and NIBUT. The results were analyzed using SPSS according to the level of PM. Results : On the day of bad PM level, the tear volume and stability were significantly decreased both wearing glasses and CL (p＜0.050) on to the level of dry eye. With the CL wearing tear volume was decreased even on the day of good PM level and TBUT was decreased on the day of bad PM level compared with glasses wearing. In dry eye group, TBUT was decreased significantly with CL wearing compared with normal group on the day of bad PM level. Conclusion : PM reduces both the amount and stability of tear that it could be the one of causes of dry eye, and wearing CL at the bad PM level deteriorated the tear film stability that the symptoms of dry eye patients may be worsened, so it is thought that wearing glasses should be recommended for contact lens wearers on the day of bad PM to prevent the dry eye.

Changes of tear lipid mediators after eyelid warming or thermopulsation treatment for meibomian gland dysfunction

Meibomian gland dysfunction (MGD) represents a major cause of dry eye and ocular discomfort. Lipid mediators, often termed oxylipins, can be produced enzymatically or non-enzymatically, and may modulate inflammatory processes in MGD. Here, we aimed to assess the longitudinal changes of lipid mediators after various eyelid treatments (eyelid warming and thermopulsation) over 12 weeks. Secondly, we aimed to assess the chirality of mono-hydroxyl lipid mediators from tears of MGD and healthy participants.Tears lipid mediators were extracted from Schirmer's strips and levels were quantified by liquid chromatography mass spectrometry (LC–MS) techniques. We quantified 33 lipid mediators in the tear, 18 of which (including 11-HETE, 20−OH-LTB4, and 15-oxoETE) were reduced significantly after treatment. Changes in concentrations of 10-HDoHE (r = 0.54) and 15-oxoETE (r = 0.54) were correlated to the number of meibomian gland plugs at baseline, so increased severity of MGD was associated with treatment-induced change in lipid mediators.The chiral analysis demonstrated that 5(S)-HETE, 12(S)-HETE, 15(S)-HETE, 14(S)-HDoHE, 17(S)-HDoHE and 11(R)-HETE were produced with significant enantiomeric excess (ee %) in controls compared to patients, due to enantiomer selective enzymatic action, whereas most lipid mediators were racemates in patients, due to dominance of oxidative effects which have no enantiomeric preference. Treatment of MGD restored the concentrations of 15(S)-HETE, 14(S)-HDoHE and 17(S)-HDoHE with significant ee values, suggesting reduction in oxidative action. Overall, MGD therapy reduced pro-inflammatory molecules generated by lipoxygenase and oxidative stress.

Isolated bilateral congenital lacrimal gland agenesis presenting as dry eye in childhood: a rare entity

We report the case of a 1-year-old child who presented with complaints of redness and defective vision since birth. The child had no systemic abnormalities. On examination, complete keratinization of the bulbar conjunctiva and cornea was noted with dry, lustreless and irregular surface. Corneal sensation was intact. Orbital MRI revealed bilateral agenesis of the lacrimal gland with normal salivary glands. The child was given vitamin supplementation, cyclosporine eye drops along with lubricants and tape tarsorrhaphy in the night. Permanent occlusion of both the lower puncta was done. There was decreased ocular surface congestion, with frequent wetting of the ocular surface, which continued in the months to follow. We present a case of isolated bilateral lacrimal gland agenesis with normal salivary glands, a rare cause of dry eye in children. An early diagnosis and conservative management can help in maintaining functional vision in such cases.

Diagnostic Test Efficacy of Meibomian Gland Morphology and Function

Meibomian gland dysfunction (MGD) is the leading cause of dry eye and proposed treatments are based on disease severity. Our purpose was to establish reliable morphologic measurements of meibomian glands for evaluating MGD severity. This retrospective, cross-sectional study included 100 MGD patients and 20 controls. The patients were classified into dry eye severity level (DESL) 1–4 based on symptoms and clinical parameters including tear-film breakup time, ocular staining and Schirmer I. The gland loss, length, thickness, density and distortion were analyzed. We compared the morphology between patients and controls; examined their correlations to meibum expressibility, quality, and DESL. Relative to controls, the gland thickness, density and distortion were elevated in patients (p < 0.001 for all tests). The area under the receiver operating characteristic curve was 0.98 (95% confidence interval [CI], 0.96–1.0) for gland loss, and 0.96 (CI 0.91–1.0) for gland distortion, with a cutoff value of six distorted glands yielding a sensitivity of 93% and specificity of 97% for MGD diagnosis. The gland distortion was negatively correlated to the meibum expressibility (r = −0.53; p < 0.001) and DESL (r = −0.22, p = 0.018). In conclusion, evaluation of meibomian gland loss and distortion are valuable complementary clinical parameters to assess MGD status.

&lt;p&gt;Intraductal meibomian gland probing: background, patient selection, procedure, and perspectives&lt;/p&gt;

Obstructive meibomian gland dysfunction is the most common cause of dry eye. Its conventional treatment has focused on using heat and pressure with anti-inflammatory and antimicrobial therapies but has often been a frequent, frustrating experience for patient and physician. New evidence from Meibomian gland intraductal probing suggests fixed intraductal strictures and obstruction correlating to periductal fibrosis first described in 1997. The use of intraductal probing has been reported, by this author and in at least ten independent peer-reviewed academic papers from around the world, to consistently lead to statistically significant improvement in signs and symptoms of gland dysfunction including cases refractory to other extensive treatments. This review will focus on the background of meibomian gland intraductal probing as well as patient selection, procedure, and perspectives.

To study prevalence of dry eyes in diabetic patients

Introduction: One of the most important cause of dry eye is diabetes mellitus. Longer the duration of diabetes in a patients, higher is the chance of developing dry eye. Level of blood sugar in diabetic patients also has a role to play in causing dry eye disease. It is seen that dry eye disease is more common in patients with poor blood sugar control. In India, not much studies has been done on dry eyes in diabetic patients. This study was carried out in an attempt to find out prevalence of dry eye in diabetic patients. Materials and Methods: Hospital based prevalence study of hundred patients with type II diabetes was conducted in SRM medical college and hospital between august 2012 and July 2013.Detailed diabetic history, slit lamp bio microscopy, Schirmers test, tear break up time, fluorescein staining, Rose Bengal staining were done, along with a standard questionnaire. Results: Forty three (43%) type II diabetes patients had dry eye in our study. A significant association is found in dry eye with poor glycaemic control [p-0.001] and with longer duration of diabetes [p Conclusion: Good glycaemic control is essential to reduce the prevalence of dry eye. Examination of dry eye should be considered as an integral part in the assessment of diabetic eye diseases. Keywords: Diabetes mellitus, Glycaemic control, Prevalence, Dry eye.

Dry eye after whole brain radiation: Analysis from a prospective study.

198 Background: Lacrimal glands (LGs) receive incidental dose of unknown significance in patients undergoing whole brain radiation therapy (WBRT). Median survival following diagnosis of brain metastases is poor, so quality of life is of utmost importance for these patients. We enrolled patients on a prospective observational cohort study with an endpoint of dry eye syndrome, which is not thought to be a toxicity of WBRT. Methods: Patients receiving WBRT for any diagnosis to a total dose of 25 to 40 Gy in 10 to 20 fractions were eligible. Patients received 3D-conformal WBRT using opposed lateral fields covering the skull and C1 or C2 vertebrae. LGs were not prospectively contoured before treatment but were subsequently contoured for dosimetric analysis. Patients completed the single-question Subjective Evaluation of Symptom of Dryness (5-point Likert scale) at baseline, immediately after WBRT (EndRT), 1 month (1M), 3 months (3M), and 6 months (6M). The primary endpoint was change in proportion of patients at 1M experiencing moderate or worse dry eye (defined as symptoms that cause discomfort and interfere with activities). Orbital dose was analyzed as a surrogate for LG dose as LGs were difficult to contour on computed tomography (CT) imaging. Results: 73 enrolled patients were eligible for analysis. There were 69 evaluable patients at EndRT, 55 at 1M, 33 at 3M, and 28 at 6M. Most patients received 30 Gy in 10 fractions. Median bilateral orbit mean dose was 17 Gy. Median bilateral lacrimal mean dose was 25 Gy. Median survival was 8 months. At baseline, 4% of patients had moderate or worse dry eye versus 9% at EndRT, 11% at 1M (1-tailed sign test, p = 0.031), 9% at 3M, and 7% at 6M. No significant relationship was noted between presence of dry eye and CT-contoured lacrimal gland or orbit doses. Conclusions: WBRT appears to cause a small increase in dry eye symptoms. A correlation between dry eye and LG dose was not observed, perhaps due to the overall low rate of toxicity, uncertainty in CT-based contouring of the LGs, set-up variations between planned and delivered doses, and the possibility of non-radiation causes of dry eye. Nonetheless, physicians should be aware of the possible occurrence of dry eye after WBRT, given its potential effects on quality of life.

Medical Treatment for Dry Eye in Japan.

The etiology of dry eye has not been clarified. In the United States, the inflammation theory is supported as the main cause of dry eye, whereas the Asia Dry Eye Society has identified tear instability as the main cause. Based on this tear instability concept, the P2Y2 antagonist Diquas and the mucin secretagogue Mucosta were developed and launched in Japan over the last 5 years, and they have been widely prescribed to patients with dry eye. Moreover, Diquas has also been launched in other Asian countries, such as Korea, Thailand, and Vietnam. This report summarizes the efficacy and characteristics of these two eye drops to improve our understanding of dry eye.