Clinical Scorecard: Dry Eye Dx and Tx: Treat Dry Eye Before Specialty CL Fitting

At a Glance

Key Highlights

• Undiagnosed and undertreated dry eye, MGD, and blepharitis commonly cause patient dissatisfaction with specialty contact lenses.
• Validated dry eye symptom questionnaires (e.g., CLDEQ-8, SPEED, OSDI, DEQ-5, DEQS) should be used at initial visits to identify ocular surface disease.
• Pre-treatment and ongoing management of ocular surface and lid disease improves specialty lens outcomes and patient satisfaction.

Guideline-Based Recommendations

Diagnosis

• Use validated dry eye questionnaires tailored to patient history and symptoms at initial evaluation.
• Perform thorough slit lamp and external exam documenting lid condition, ocular surface staining, and meibomian gland function.
• Obtain detailed patient history focusing on dry eye symptoms and contact lens tolerance.

Management

• Develop individualized ocular surface treatment plans prior to specialty lens fitting.
• Provide patients with written instructions on ocular surface treatments to maintain during lens wear.
• Counsel patients on the importance of consistent management of lid disease and dry eye for lens success.

Monitoring & Follow-up

• Regularly assess ocular surface and lid health during follow-up visits.
• Monitor patient symptoms and lens comfort to adjust treatment as needed.

Risks

• Failure to diagnose and treat dry eye and lid disease can lead to patient dissatisfaction, lens intolerance, and poor visual outcomes.

Patient & Prescribing Data

Patients requiring specialty or scleral contact lenses, often with complex ocular surface conditions

Successful specialty lens wear depends on preemptive dry eye and lid disease management, patient education, and adherence to treatment regimens.

Clinical Best Practices

• Incorporate dry eye symptom questionnaires routinely at initial specialty lens evaluations.
• Document ocular surface and lid findings meticulously before lens fitting.
• Set realistic patient expectations regarding the effort and consistency needed for ocular surface management.
• Treat dry eye and lid disease proactively to optimize specialty lens comfort and visual outcomes.
• Provide clear, written treatment instructions to enhance patient compliance.

References

• Stapleton F et al. Dry eye disease in the young: A narrative review. Ocul Surf. 2024
• Dossari SK et al. Prevalence of dry eye disease and its risk factors among the general population of Saudi Arabia. Cureus. 2022