The Madrid triple classification of dry eye

Area of Science:

• Ophthalmology
• Clinical Medicine

Background:

• Dry Eye Disease (DED) presents complex clinical challenges due to diverse etiologies, pathological manifestations, and severity grades.
• Effective management of dysfunctional tear film syndrome requires a systematic approach to these parameters.

Purpose of the Study:

• To introduce a comprehensive triple classification system for Dry Eye Disease.
• To aid clinicians in accurately diagnosing and grading DED for optimized treatment strategies.

Main Methods:

• Developed a three-part classification system for DED.
• Etiologic classification includes ten groups (e.g., age-related, hormonal, inflammatory).
• Anatomopathologic classification uses the ALMEN acronym (aquodeficiency, lipodeficiency, mucodeficiency, epitheliopathy, non-ocular exocrine affectations).
• Severity is graded into five levels: subclinical, mild, moderate, severe, and disabling.

Main Results:

• The etiologic classification encompasses ten distinct etiological categories with numerous variants.
• The ALMEN classification provides a structured approach to identifying underlying pathological mechanisms.
• Severity grading ranges from subclinical symptoms to disabling visual impairment, allowing for precise patient stratification.

Conclusions:

• This triple classification system provides a standardized framework for understanding and managing Dry Eye Disease.
• Accurate classification of etiology, pathology, and severity is crucial for effective DED treatment.
• The proposed system empowers dacryologists to personalize patient care for dysfunctional tear film syndrome.