- The recent Ophthalmology Innovation Summit’s dry eye disease (DED) webinar proved DED is no dry subject.
- As is usual, the webinar was split into two sections, with the second offering panel discussions on DED.
- Several issues were addressed including generic medicines, DED in youth, and market growth.
Have you ever watched a beautifully sad film, a real tearjerker, something that leaves no dry eye in the house? Parting is such sweet sorrow, but as Gandalf the wizard once said, “I will not say do not weep for not all tears are an evil.” This pretty much sums up the feelings the Media MICE team experiences at the end of an Ophthalmology Innovation Summit (OIS) webinar.
The Dry Eye Innovation Summit was a fascinating offering into one of the hot topics of ophthalmology: dry eye disease (DED). In our previous article on the webinar, we covered several cutting-edge companies that presented their products and technologies. The second part shifted to a panel format with two separate sections covering clinical and industry perspectives.
DED is Beautiful in Spring
The main theme of the clinical perspective panel was inflammation and the role it plays in both DED treatment and patient outcomes. Founder and Director of Dry Eye Services and Clinical Research at the Periman Eye Institute in Seattle, Washington, USA, Dr. Laura Periman described how the discussion about inflammation and DED “made her happy,” and spoke about the importance of being able to modulate inflammation with precision. The panel’s moderator, Assistant Professor of Ophthalmology at Weill Cornell Medicine — New York Presbyterian Hospital (New York, New York, USA), Dr. Ashley Brisette concurred, emphasizing that clinicians must understand DED as an inflammatory process and not as a simple complaint of eye strain.
This led to comparisons with other inflammatory diseases like asthma and rheumatoid arthritis. Dr. Paul Karpecki, an associate professor at UPike College of Optometry/Kentucky Eye Institute (Pikeville, Kentucky, USA), said clinicians should move away from treating DED as a relatively benign disease like chapped lips, and instead recognize it as a progressive condition. This should include seasonal flare-ups too, particularly in spring and winter.
“So many DED patients are neglected and the disease is a common thread through everything we do surgically, from cornea surgery to cataracts to refractive, so really nailing it helps you have great outcomes across the board,” said Assistant Professor of Clinical Ophthalmology and Medical Director at the Bascom Palmer Eye Institute, (Miami, Florida, USA), Dr. Rahul S. Tonk. He emphasized the importance of following this thread in consultation with patients about how DED may be impacting other conditions they have.
Questioning Questionnaires
Diagnosis and following up can be difficult when patients cannot adequately explain their symptoms. The use of questionnaires to identify said symptoms was also discussed during the clinical panel. Dr. Yuna Rapoport, the director of Manhattan Eye in New York, said in the wake of the COVID-19 pandemic, questionnaires will be phased out in favor of verbal communication with patients tired of telehealth and other technology.
However, Dr. Cynthia Matossian, the founder and medical director of Matossian Eye Associates and president of the American College of Eye Surgeons (Pennington, New Jersey, USA), said questionnaires still had a place in “average clinics.” Following on from her point, Assistant Professor of Ophthalmology at Weill Cornell Medicine (New York, New York), Dr. Ana Alzaga Fernandez said it was more important to listen to the concerns of patients and adapt accordingly.
In the following industry perspective panel, patient outcomes was raised again as an issue, but more focus was given to the changing DED market. Dr. Doug Faunce, PhD, the executive director of search and evaluation, eye care and corporate strategy at Allergan (Dublin, Ireland), said the market’s trajectory would continue to expand thanks to the exponential increase in elderly populations. He added this growth is characterized by the emergence of generics for DED treatment.
Kids Staring at Screens
While older populations will continue to be the main source of DED, more pediatric patients are being treated too. According to the Global Head of Ocular Surface at Johnson & Johnson Vision Sajjad Roshanali, more patients are presenting with DED symptoms due to their overuse of electronic devices like smartphones. He said this is why a “one size fits all” approach cannot be applied to DED treatment.
Of course, it is the goal to achieve the best outcome for patients regardless of their age, but as there is no permanent cure for DED, it can be difficult for patients to accept treatment. Head of New Ophthalmic Products at Novartis (Basel, Switzerland), Jehan Tamboowalla, said the challenge in medicine development is in difficulty in measuring outcomes. This makes it difficult to put “the right medicine in the right hands.”
Senior Vice-President and Head of Ophthalmics, Oncology and LTC at Sun Pharma (Vapi, India), Mark Hagler, said the pros and cons to market leaders “going generic.” A bigger pool of patients may adopt the product, however, as the churn rate of DED patients can be high, there are still several associated risks.
Vice-President of Medical Affairs at Bausch + Lomb (Rochester, New York), Dr. Rob Kissling, brought the panel to a close. He stated that the best litmus test for clinicians treating DED is that “new medicine and techniques should be adopted when they allow the clinicians to do something they cannot currently do.” He pointed to inter-fluorinated alkane as being like a “guiding light” in DED research over the last year.
Editor’s Note: The Ophthalmology Innovation Summit Dry Eye Innovation Showcase webinar was held on March 11, 2021. Reporting for this story took place during the event.
