The goals of the TFOS DEWS II Definition and Classification Subcommittee were to create an evidence-based definition and a contemporary classification system for dry eye disease (DED). The new definition recognizes the multifactorial nature of dry eye as a disease where loss of homeostasis of the tear film is the central pathophysiological concept. Ocular symptoms, as a broader term that encompasses reports of discomfort or visual disturbance, feature in the definition and the key etiologies of tear film instability, hyperosmolarity, and ocular surface inflammation and damage were determined to be important for inclusion in the definition. In the light of new data, neurosensory abnormalities were also included in the definition for the first time. In the classification of DED, recent evidence supports a scheme based on the pathophysiology where aqueous deficient and evaporative dry eye exist as a continuum, such that elements of each are considered in diagnosis and management. Central to the scheme is a positive diagnosis of DED with signs and symptoms, and this is directed towards management to restore homeostasis. The scheme also allows consideration of various related manifestations, such as non-obvious disease involving ocular surface signs without related symptoms, including neurotrophic conditions where dysfunctional sensation exists, and cases where symptoms exist without demonstrable ocular surface signs, including neuropathic pain. This approach is not intended to override clinical assessment and judgment but should prove helpful in guiding clinical management and research.
Abstract
Journal Article
Review
eng
28736335
Craig, Jennifer P., et al. "TFOS DEWS II Definition and Classification Report." The Ocular Surface, vol. 15, no. 3, 2017, pp. 276-283.
Craig JP, Nichols KK, Akpek EK, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15(3):276-283.
Craig, J. P., Nichols, K. K., Akpek, E. K., Caffery, B., Dua, H. S., Joo, C. K., Liu, Z., Nelson, J. D., Nichols, J. J., Tsubota, K., & Stapleton, F. (2017). TFOS DEWS II Definition and Classification Report. The Ocular Surface, 15(3), 276-283. https://doi.org/10.1016/j.jtos.2017.05.008
Craig JP, et al. TFOS DEWS II Definition and Classification Report. Ocul Surf. 2017;15(3):276-283. PubMed PMID: 28736335.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - TFOS DEWS II Definition and Classification Report.
AU - Craig,Jennifer P,
AU - Nichols,Kelly K,
AU - Akpek,Esen K,
AU - Caffery,Barbara,
AU - Dua,Harminder S,
AU - Joo,Choun-Ki,
AU - Liu,Zuguo,
AU - Nelson,J Daniel,
AU - Nichols,Jason J,
AU - Tsubota,Kazuo,
AU - Stapleton,Fiona,
Y1 - 2017/07/20/
PY - 2017/05/05/received
PY - 2017/05/06/accepted
PY - 2017/7/25/pubmed
PY - 2018/5/15/medline
PY - 2017/7/25/entrez
KW - Aqueous deficient
KW - Classification
KW - Definition
KW - Dry eye disease
KW - Evaporative
KW - Mechanism
SP - 276
EP - 283
JF - The ocular surface
JO - Ocul Surf
VL - 15
IS - 3
N2 - The goals of the TFOS DEWS II Definition and Classification Subcommittee were to create an evidence-based definition and a contemporary classification system for dry eye disease (DED). The new definition recognizes the multifactorial nature of dry eye as a disease where loss of homeostasis of the tear film is the central pathophysiological concept. Ocular symptoms, as a broader term that encompasses reports of discomfort or visual disturbance, feature in the definition and the key etiologies of tear film instability, hyperosmolarity, and ocular surface inflammation and damage were determined to be important for inclusion in the definition. In the light of new data, neurosensory abnormalities were also included in the definition for the first time. In the classification of DED, recent evidence supports a scheme based on the pathophysiology where aqueous deficient and evaporative dry eye exist as a continuum, such that elements of each are considered in diagnosis and management. Central to the scheme is a positive diagnosis of DED with signs and symptoms, and this is directed towards management to restore homeostasis. The scheme also allows consideration of various related manifestations, such as non-obvious disease involving ocular surface signs without related symptoms, including neurotrophic conditions where dysfunctional sensation exists, and cases where symptoms exist without demonstrable ocular surface signs, including neuropathic pain. This approach is not intended to override clinical assessment and judgment but should prove helpful in guiding clinical management and research.
SN - 1937-5913
UR - https://www.unboundmedicine.com/prime/citation/28736335/TFOS_DEWS_II_Definition_and_Classification_Report_
L2 - https://linkinghub.elsevier.com/retrieve/pii/S1542-0124(17)30119-2
DB - PRIME
DP - Unbound Medicine
ER -
