What’s NEW? It is DEWS II!
Laura Periman, MD
#PutYourBootsOn – Part I
Originally Published on Ophthalmology Management
As the granddaughter of Montana ranchers, I grew up hearing “That’s darn ‘bout as easy as herding cats.” A saying that struck me with the creation of DEWS II. From around the globe, 150 clinical and scientific experts gathered to create an evidence-based consensus on Ocular Surface Disease (OSD) definitions, epidemiology, pathophysiology, iatrogenic, therapeutic and more.
They took all of the scientific, diagnostic and interventional advancements since the first DEWS report in 2007 and organized it into an approachable algorithm. This algorithm (Figure 1) provides insight into the thinking of seasoned OSD treating clinicians and is a clear diagnostic and therapeutic roadmap. This organization helps to provide a visual “Cliff’s Notes” version of the vast expansion of knowledge and publications over the last 10 years. A welcome bonus for the all too busy clinicians and surgeons.
Figure 1. The DEWS II classification algorithm. Image courtesy of Elsevier, reused with permission.
| Ask ten different clinicians how they handle OSD and you will likely get ten different answers. This can lead to variable experiences and confidences with new diagnostics, therapeutics and interventions. By having a place where the best information has been collected, discussed and consensus organized, we have a common foundation for advancing our collective understanding of OSD. It feels to me a bit like the BCSC (Basic Clinical and Science Course) series we are all issued in ophthalmology residency. I still have a fond attachment to mine, all highlighted up, notes in the margins, tattered edges and all.
Most ophthalmologists are visual learners. Show us a picture or see an eye through the slit lamp and we get it. The organizational algorithm flow chart not only helps to demystify the approaches to a complex, multifactorial disease state, it is an efficient visual representation of a tremendous body of work. And next month is when we start discussing the chart… |
| The entire TFOS DEWS II report is available to all for free at www.TearFilm.org. |
Laura M. Periman, MD is Director of Dry Eye Services and Clinical Research at Evergreen Eye Center in Seattle, WA. Relevant to this series, she discloses relationships with Allergan, Bio-Tissue, Eyedetec, Lumenis, Science Based Health, Sun Pharmaceuticals, TearLab, Topcon and Visant.