Dry eye disease and microbial keratitis: is there a connection?

Area of Science:

• Ophthalmology and Immunology
• Ocular Surface Disease
• Innate Immunity

Background:

• Dry eye disease (DED) is a prevalent condition characterized by ocular surface inflammation and hyperosmolarity.
• A disrupted ocular surface in DED is a known risk factor for microbial infection.
• Despite the risk, severe ocular infections are uncommon in typical DED patients, implying robust defense mechanisms.

Purpose of the Study:

• To review the epidemiology of ocular surface infections in patients with dry eye disease.
• To examine laboratory findings on innate immune mechanisms at the ocular surface.
• To understand how these innate immune mechanisms are altered in human DED and animal models.

Main Methods:

• Comprehensive literature review of epidemiological studies on ocular infections in DED.
• Analysis of laboratory-based research investigating ocular surface innate immunity.
• Inclusion of studies on both human DED patients and relevant animal models.

Main Results:

• The review synthesizes current knowledge on the interplay between DED and ocular infections.
• It highlights the critical role of innate immune responses in protecting the dry eye surface from pathogens.
• Alterations in these immune mechanisms in DED are discussed, supported by human and animal data.

Conclusions:

• The ocular surface possesses innate defense mechanisms that mitigate infection risk in dry eye disease.
• Further research is needed to fully elucidate these complex immune processes and their dysfunction in DED.
• Understanding these gaps will guide future studies to better manage DED and its complications.