title: Expert opinion in the management of aqueous Deficient Dry Eye Disease (DED).
abstract: BACKGROUND
  Dry eye disease (DED) affects millions of people worldwide. There are a variety of new treatments beyond traditional therapies such as preservative free artificial tears. Here, we conduct a survey to identify the most common treatments used among specialists and assess their interest in newer therapies.
  
  
  METHODS
  An international survey was distributed to dry eye researchers and expert practitioners via an internet survey. The survey data collected were analyzed with descriptive statistics.
  
  
  RESULTS
  One hundred and fifteen respondents completed the survey; of these, 66 % were cornea specialists. The most commonly prescribed topical treatments included cyclosporine A (CSA) 0.05 % (71/104, 68 %), fluorometholone (FML) 0.1 % (59/99, 60 %), loteprednol etabonate 0.5 % (50/99, 51 %), and autologous serum eye drops (ASD; 48/97, 49 %). The most commonly prescribed non-topical medications included essential fatty acid supplements (72/104, 69 %), low-dose doxycycline (oral; 61/100, 61 %), and flaxseed supplements (32/96, 33 %) as well as punctal plugs (76/102, 75 %). Respondents reported treatment with topical corticosteroids for 2 to 8 weeks (46/86, 53 %), followed by less than 2 weeks (24/86, 28 %) and with topical CSA between 2 to 8 weeks (45/85, 53 %) followed by 2 to 6 months (24/85, 28 %). The top three signs and symptoms reported to indicate treatment response were, in order, fluorescein staining of the cornea, reduction in foreign body sensation, and reduction in burning sensation.
  
  
  CONCLUSIONS
  This survey offers insight into current expert opinion in the treatment of DED. The results of this survey are hypothesis generating and will aid in the design of future clinical studies.
authors.affiliation: Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA. aileensy@gmail.com.|F.I. Proctor Foundation, University of California, Room S309, 513 Parnassus Ave, UCSF, San Francisco, CA, 94143-0412, USA. aileensy@gmail.com.
authors.forename: Aileen
authors.initials: A
authors.lastname: Sy
authors.affiliation: F.I. Proctor Foundation, University of California, Room S309, 513 Parnassus Ave, UCSF, San Francisco, CA, 94143-0412, USA. Kieran.obrien@ucsf.edu.
authors.forename: Kieran S
authors.initials: KS
authors.lastname: O'Brien
authors.affiliation: Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA, USA. Margaret.liu.md@gmail.com.
authors.forename: Margaret P
authors.initials: MP
authors.lastname: Liu
authors.affiliation: F.I. Proctor Foundation, University of California, Room S309, 513 Parnassus Ave, UCSF, San Francisco, CA, 94143-0412, USA. puja.cuddapah@ucsf.edu.
authors.forename: Puja A
authors.initials: PA
authors.lastname: Cuddapah
authors.affiliation: F.I. Proctor Foundation, University of California, Room S309, 513 Parnassus Ave, UCSF, San Francisco, CA, 94143-0412, USA. nisha.acharya@ucsf.edu.|Department of Ophthalmology, University of California, San Francisco, CA, USA. nisha.acharya@ucsf.edu.
authors.forename: Nisha R
authors.initials: NR
authors.lastname: Acharya
authors.affiliation: F.I. Proctor Foundation, University of California, Room S309, 513 Parnassus Ave, UCSF, San Francisco, CA, 94143-0412, USA. tom.lietman@ucsf.edu.|Department of Ophthalmology, University of California, San Francisco, CA, USA. tom.lietman@ucsf.edu.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Lietman
authors.affiliation: F.I. Proctor Foundation, University of California, Room S309, 513 Parnassus Ave, UCSF, San Francisco, CA, 94143-0412, USA. Jennifer.rose-nussbaumer@ucsf.edu.|Department of Ophthalmology, University of California, San Francisco, CA, USA. Jennifer.rose-nussbaumer@ucsf.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rose-Nussbaumer
mesh_terms: D018926:Anti-Allergic Agents / Q000008:administration & dosage; D001082:Aqueous Humor; D016572:Cyclosporine / Q000008:administration & dosage; D004318:Doxycycline / Q000008:administration & dosage; D019597:Flax; D005469:Fluorometholone / Q000008:administration & dosage; D005938:Glucocorticoids / Q000008:administration & dosage; D019538:Health Care Surveys; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007638:Keratoconjunctivitis Sicca / Q000628:therapy*; D007765:Lacrimal Apparatus / Q000601:surgery; D000069559:Loteprednol Etabonate / Q000008:administration & dosage; D010818:Practice Patterns, Physicians'; D019919:Prosthesis Implantation; D044967:Serum; D012859:Sjogren's Syndrome / Q000628:therapy*
chemical_list: D018926:Anti-Allergic Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D004318:Doxycycline; D005469:Fluorometholone; D000069559:Loteprednol Etabonate