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A New Perspective on Dry Eye Classification: Proposal by the Asia Dry Eye Society
Kazuo Tsubota1, Norihiko Yokoi, Hitoshi Watanabe
1Department of Ophthalmology (K.T., M.D., T.K.), Keio University School of Medicine, Tokyo, Japan; Department of Ophthalmology (N.Y., S.K.), Kyoto Prefectural University of Medicine, Kyoto, Japan; Eye Division (H.W.), Kansai Rosai Hospital, Amagasaki, Japan; Japanese Red Cross Gifu Hospital (T.K.), Gifu, Japan; Eye Center (M.Y.), Kyorin University School of Medicine, Tokyo, Japan; Department of Ophthalmology (H.-M.K.), Korea University Anam Hospital, Seoul, Korea; Department of Ophthalmology (H.-W.T.), Ulsan University Asan Medical Center, Seoul, Korea; Department of Ophthalmology (J.Y.H.), Seoul National University, Seoul National University Bundang Hospital, Seoul, Korea; Department of Ophthalmology (K.C.Y.), Chonnam National University Hospital, Gwangju, Korea; Department of Ophthalmology (K.Y.S.), Yonsei University Severance Hospital, Seoul, Korea; Department of Ophthalmology (X.S.), Beijing Tongren Eye Center, Beijing Institute of Ophthalmology, Beijing, China; Cornea Service (W.C.), The Affiliated Eye Hospital of Wenzhou Medical University, Menzhou, China; Zhongshan Ophthalmic Center Sun Yat-Sen University (L.L.), Guangzhou, China; Department of Ophthalmology (M.L.), Peking University International Hospital, Beijing, China; Singapore National Eye Center (L.T.), Singapore; Department of Ophthalmology (F.-R.H.), National Taiwan University Hospital, Taipei, Taiwan; Department of Ophthalmology (V.P.), Chulalongkorn University (V.P.), Bangkok, Thailand; Department of Ophthalmology (R.L.-B.-S.), University of the Philippines, Manila, Philippines; International Specialist Eye Centre/National University Hospital (T.K.Y.), Kuala Lumpur, Malaysia; and Eye Institute of Xiamen University (Z.L.), Xiamen, China; and Department of Ophthalmology (J.S.), Tokyo Dental College, Ichikawa, Japan.
The Asia Dry Eye Society (ADES) developed a simple, practical classification for dry eye disease. This tear film-oriented approach categorizes dry eye into three types, aiding diagnosis and treatment.
Area of Science:
- Ophthalmology
- Ocular Surface Disease
Background:
- Dry eye disease is a multifactorial condition characterized by an unstable tear film, leading to symptoms and potential ocular surface damage.
- The Asia Dry Eye Society (ADES) previously defined dry eye and emphasized tear film instability and visual dysfunction.
- Tear film-oriented therapy focuses on addressing deficiencies in tear film layers and ocular surface epithelium.
Purpose of the Study:
- To propose a simple classification of dry eye disease based on tear film-oriented diagnosis.
- To integrate diagnostic criteria and classification for practical clinical use.
- To provide a straightforward tool for effective dry eye diagnosis and treatment.
Main Methods:
- Proposed a classification system based on the concept of tear film-oriented diagnosis.
- Identified three primary types of dry eye: aqueous-deficient, decreased wettability, and increased evaporation.
- Recommended practical diagnosis using fluorescein tear breakup patterns.
Main Results:
- The proposed classification aligns with issues in specific tear film layers: aqueous, mucin, and lipid.
- Fluorescein tear breakup pattern analysis is suggested as a practical diagnostic method.
- The classification system is designed to be simple and usable by various eye care professionals.
Conclusions:
- The ADES classification offers a straightforward and practical approach to diagnosing dry eye disease.
- This system facilitates effective diagnosis and treatment by categorizing dry eye into three distinct types.
- The use of fluorescein breakup patterns makes the diagnosis accessible even to non-specialists.
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