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Advancing the Treatment of Dry Eye Disease

By: Derek Cunningham, OD; Art Epstein, OD; Kelly Nichols, OD, MPH, PhD; Walt Whitley, OD, MBA

This course has expired. You can still review the content but course credit is no longer available.

Supplement Credits: 2

The target audience for this CE Activity is optometrists.

This educational activity consists of a supplement and 20 study questions. To obtain credit, the participant should read the learning objectives contained at the beginning of this activity, read the material, answer all questions in the post test, and complete the activity evaluation Form. This educational activity should take a maximum of 2.0 hours to complete. Please follow the instructions provided below in the section entitled.

It is estimated that 25 million Americans suffer from dry eye disease (DED) and that $3.8 billion is spent on DED symptom relief annually in the United States.1 DED results in ocular discomfort, visual disturbances, contact lens dropout, and may lead to ocular surface damage. Meibomian gland dysfunction is a leading cause of evaporative DED2 and is frequently found in aqueous-deficient DED,3 making it one of the most common diseases observed in eye care clinics. However, it remains one of the most underdiagnosed.4,5

In order to reduce patient discomfort and improve ocular surface health, it is critical that practitioners address the various underlying causes of what is broadly known as DED. In the last few years, numerous studies have demonstrated that the health of the ocular surface is a significant factor to success with any anterior segment patient, and much work has been done to establish the risk factors, symptoms, causes, and treatment options for DED. However, the methodology preferences for evaluating and treating ocular surface disease remain disperse.

1. O’Brien PD, Collum LM. Dry eye: diagnosis and current treatment strategies. Curr Allergy Asthma Rep.
2. Nelson JD, Shimazaki J, Benitez-del-Castillo JM, et al. The international workshop on meibomian gland dysfunction:
report of the definition and classification subcommittee. Invest Ophthalmol Vis Sci. 2011;52(4):1930–1937.
3. Nichols KK, Foulks GN, Bron AJ, et al. The international workshop on meibomian gland dysfunction: executive
summary. Invest Ophthalmol Vis Sci. 2011;52(4):1922–1929.
4. Bron AJ, Tiffany JM. The contribution of meibomian disease to dry eye. Ocul Surf. 2004;2(2):149–165.
5. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of
the International Dry Eye WorkShop. Ocul Surf. 2007;5(2):75–92.

Expiration Date: Friday, March 01, 2019
Release Date: March 1, 2016

Learning Objectives

After successfully completing this activity, optometrists will have improved their ability to:

  • Understand the latest estimates on the prevalence of dry eye disease
  • Understand the importance of a thorough examination of the ocular surface and adnexia
  • Identify the type of evaluations that will allow a definitive diagnosis
  • Understand new evidence regarding the inflammatory pathway
  • Apply new treatment strategies meant to increase efficacy of dry eye treatments
  • Understand the importance of early symptom relief for dry eye treatments
  • Apply evidence-based medicine in selecting a course of treatment

Accreditation and Designation Statement

This course is COPE approved for 2.0 hour of CE credit for optometrists.

Faculty and Disclosures

• Derek Cunningham, OD

• Arthur Epstein, OD

• Kelly Nichols, OD, MPH, PhD

• Walt Whitley, OD, MBA

Derek Cunningham, OD, had a financial relationship during the past year with the following commercial interests in the form of Consultant: Abbott Medical Optics Inc.; Advanced Tear Diagnostics; Alcon; Allergan, Inc.; ArticDx Inc.; Bausch + Lomb; Bio-Tissue; Glasses Off; TearLab Corporation. Grant/Research Support: Abbott Medical Optics Inc.; Alcon; Lumenis; Marco Ophthalmic Inc; and Optovue, Inc.

Arthur Epstein, OD had a financial relationship during the past year with the following commercial interests in the form of Consultant/Speaker’s Bureau: Alcon; BioD LLC; Bio-Tissue; NovaBay Pharmaceuticals, Inc.; PRN Pharmaceutical Research Network LLC; Oculus, Inc.; TearLab Corporation; and TearScience. Grant/Research Support: Alcon; NovaBay Pharmaceuticals, Inc.

Kelly Nichols, OD, MPH, PhD, had a financial relationship during the past year with the following commercial interests in the form of Consultant: Eleven Biotherapeutics; Insight Pharmaceuticals; Kala Pharmaceuticals; Parion Sciences Inc.; Shire Pharmaceuticals; and Sun Pharmaceutical Industries Ltd. Grant/Research Support: Eleven Biotherapeutics; Kala Pharmaceuticals; and Shire Pharmaceuticals.

Walt Whitley, OD, MBA, had a financial relationship during the past year with the following commercial interests in the form of Consultant/Speaker’s Bureau: Alcon; Bausch +Lomb.

Each of the contributing physicians listed above has attested to the following: (1). that the relationships/affiliations noted will not bias or otherwise influence his or her involvement in this activity; (2). that practice recommendations given relevant to the companies with whom he or she has relationships/affiliations will be supported by the best available evidence or, absent evidence, will be consistent with generally accepted medical practice; and (3). that all reasonable clinical alternatives will be discussed when making practice recommendations.


The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of The State University of New York College of Optometry, Evolve Medical Education LLC, Shire Pharmaceuticals, or Advanced Ocular Care .

Please refer to the official product information for each product for discussion of approved indications, contraindications, and warnings.

This COPE CE Activity is supported through an unrestricted educational grant from Shire Pharmaceuticals.

Advancing the Treatment of Dry Eye Disease

Derek Cunningham, OD; Art Epstein, OD; Kelly Nichols, OD, MPH, PhD; Walt Whitley, OD, MBA