Eyeworld Supplements

continued from previous page © Copyright 2025 ASCRS Ophthalmic Corporation. All rights reserved. The views expressed here do not necessarily reflect those of the staff and leadership of EyeWorld and ASCRS and in no way imply endorsement by EyeWorld and ASCRS. OCULAR SURFACE DISEASE IN MY SURGICAL PRACTICE: BEST MANAGEMENT SOLUTIONS surgical delays. He would also treat this patient with topical steroids for the inflammation as well as perfluorohexyloc- tane drops for the evaporative component. Dr. Mah mentioned that he would use a long-term immunomodulator since you wouldn't keep the patient on steroids long term. Dr. Farid said the patient got better but she still has a lot of punctate keratitis, though she never complained of pain. When Dr. Farid brought the patient back and checked corne- al sensitivity testing, both corneas had diminished sensation. Dr. Mah said he has started patients like this on Oxervate (cenegermin, Dompé), and he has used serum. He suggested Oxervate might be needed in a severe case like this. Autologous serum drops often provide enough trophic growth factors to help the epithelial healing and improve ocular surface staining. The detection and treatment of ocular surface disease in the preoperative cataract setting is critical to getting the best results for patients, according to Dr. Farid. Have a low threshold for suspecting OSD and an aggressive approach to treating before proceeding with surgical planning. tree oil and derivatives, and intense pulsed light therapy. The only approved option is lotilaner 0.25%. Dr. Farid said she goes right to the lotilaner option to treat these patients because it's an effective treatment. Dr. Starr agreed that it works well, but it's also a 6-week course of treatment, so you need that time prior to surgery. Dr. Ayres also noted OSD treatments on the horizon, like AR-15512, a topical transient receptor potential melastatin 8 agonist (Alcon), reproxalap (Aldeyra), and AZR-MD-001, selenium sulfide in an ophthalmic ointment (Azura Ophthalmics). Case presentation Wrapping up the session, Dr. Farid led a discussion of an additional case presentation. It was a 57-year-old woman with significant photo- phobia and blurry vision. The patient had symptoms that prevented her from reading or working on her computer for long hours. She was also a type 1 diabetic and had seasonal allergies and mild depression. On exam, there was a lot of ocular surface staining, positive InflammaDry, and high tear osmolarity. Dr. Farid questioned where to start with this patient: 1) tear volume, 2) inflammation, 3) lid margin, or 4) tear quality/nutrition. Dr. Ayres said this patient had a very severe exam and he was worried that there was a neurotrophic component. He suggested getting rid of some of the medications and antihistamines and looking at the lid margin. Stopping the offending agent and treating inflammation is a great place to start, Dr. Farid said. Dr. Starr also suggested using punctal plugs because the patient's tear meniscus looked very low, and the corneal staining was severe. Plugs increase tear volume instanta- neously and can help convert VS-OSD quickly to minimize Thank you to the sponsors of this program Diamond level: Platinum level: Gold level: Have a low threshold for suspecting OSD and an aggressive approach to treating before proceeding with surgical planning. —Marjan Farid, MD

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