Although it may seem paradoxical, dry eye disease is so prevalent that it often goes unnoticed. How can something be pervasive and yet invisible? Many people who experience the chronic discomfort brought on by tear film dysfunction simply assume “that’s the way it is” and learn to live with it, barely realizing that they have a chance at a better quality of life. But these people suffer in silence needlessly. 

They walk among us, the DED. You see plenty in your practice every day—I’ll bet one’s in the waiting room right now—whether or not the conversation ever happens. Some of the walking DED even edit optometry magazines and should know enough about the topic to bring it up with their own optometrists, but don’t. I know of at least one person who fits the bill there. 

And, of course, literally millions more cases of DED are inevitable in the coming years, given the condition’s links to age-related changes and the ubiquity of digital device use in our lives, which reduces blink frequency and disrupts the tear film, exacerbating dry eye.

Fortunately, eye doctors—and the companies that make products to help them—do seem to be giving dry eye more priority in recent years. Once dismissed as either a nuisance to be brushed off or a genuine problem that lacks good long-term solutions, dry eye disease has increasingly been front and center at research labs, industry R&D departments and optometrists’ offices.

Since the prevailing opinion is that meibomian gland dysfunction is the driver of most cases, we’ve made that component of dry eye the focus of this month’s 17th Annual Dry Eye Report. Over the course of three feature articles, our contributors discuss in detail the anatomy of the meibomian glands, causes and consequences of dysfunction, better methods of clinical observation and a wide range of options for prevention and treatment. 

We also welcome guest columnist Whitney Hauser, OD, to this month’s “Ocular Surface Review” department. Dr. Hauser discusses the relationship between dry eye and depression (in particular, the drugs that treat it).

We hope you come away from this issue’s dry eye coverage better prepared to discuss and intervene for your patients, even—perhaps especially—the ones who don’t realize they have or may develop DED.

It Was 20 Years Ago Today

This issue also includes the 20th anniversary edition of the Clinical Guide to Ophthalmic Drugs by Randall Thomas, OD, and Ron Melton, OD, two names synonymous with clinical expertise. I worked with Drs. Melton and Thomas to put out that first supplement in 1996, when treatment of eye disease by optometrists still seemed a little radical. Now it’s the norm. I think it’s fair to give credit where credit is due and acknowledge the role these two educators played in moving the profession forward. Many thanks to you both.