Current and emerging therapy of dry eye disease. Part A: pharmacological modalities

Abstract

Introduction: Dry eye disease (DED) is an important public health problem considering its prevalence, morbidity, and cost implications. In the last two decades, new insight on the pathogenesis of dry eye has resulted in development of novel therapeutic modalities. Areas covered: This review will discuss current and emerging pharmacological modalities in treatment of DED to include tear supplements, anti-inflammatory therapy, antibiotics, vitamin A, other vitamins and antioxidants, free amino acids, essential fatty acids, hormone replacement therapy, mucolytics, tear stimulation (secretagogues) and biological tear substitutes. In preparing this review, a Medline, PubMed and Cochrane Database search of the medical literature for the period between January 1978 and July 2016 using a wide range of keywords was conducted. Only treatment modalities that had their efficacy and safety investigated in clinical studies are included. Expert commentary: Many patients have multiple mechanisms contributing to DED and appropriateness of each available treatment should be considered on a case-by-case bases. There are multiple therapeutic agents under investigation in the pre-clinical stage, which have promising data in treating DED.