Aqueous-Deficient Dry Eye Disease: Evaluation and Management

This opening chapter describes the evaluation and management of three patients with increasing severity of aqueous-deficient dry eye disease (AD-DED) (the management of meibomian gland disease, which frequently coexists with aqueous deficiency, is discussed in Chap. 2). The diagnosis and management of these three cases follows the Dry Eye Workshop (DEWS) recommendation which is based on the severity levels (Table 1.1). In Case 1, with mild dry eye disease (severity level 1), the emphasis is on proper history and counseling with lifestyle modifications. Case 2, with more moderate disease (severity level 2), highlights the use of anti-inflammatory therapy and the option of punctal plugs. Case 3, with more severe disease (severity level 3), discusses the advanced treatment options including total punctal occlusion, serum tears, and scleral lenses.