Characterization of Individuals with High-Frequency Artificial Tear Supplement Use

Area of Science:

• Ophthalmology
• Dry Eye Disease Research
• Ocular Surface Disease

Background:

• High-frequency topical eye drop usage is common in dry eye disease management.
• Understanding predisposing factors for frequent use is crucial for effective treatment strategies.

Purpose of the Study:

• To identify dry eye parameters associated with high-frequency artificial tear usage.
• To estimate the prevalence of high-frequency eye drop use in a dry eye patient cohort.
• To evaluate the impact of reduced drop usage and the need for advanced treatments like cyclosporine.

Main Methods:

• A cohort of 5594 dry eye patients was analyzed, categorizing users as high (≥1 drop/hour) or low (<4 drops/day).
• Evaluated differences in dry eye symptoms (OSDI, SPEED), tear parameters (SPK, FTBUT, LLT, MGE), and blink patterns.
• Assessed follow-up compliance and treatment outcomes, including cyclosporine initiation.

Main Results:

• High users exhibited significantly worse symptom scores, increased blinking, lower Schirmer scores, higher SPK, and shorter FTBUT.
• No differences were observed in lipid layer thickness or meibomian gland expressibility.
• High users showed greater follow-up compliance and a significantly higher likelihood of receiving cyclosporine treatment (15.4% vs 1.1%).

Conclusions:

• Elevated OSDI (>40), SPEED (>12), and low Schirmer scores (≤3 mm) predict high-frequency eye drop use.
• High-frequency use, seen in 3.2% of patients, may involve environmental trigger hypersensitivity.
• Frequent users demonstrate a significantly greater need for advanced therapies such as cyclosporine.