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P. A. Asbell, S. Speigel; Survey: Ophthalmologist Perceptions Regarding Treatment of Moderate to Severe Dry Eye. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4666.
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To understand ophthalmologists’ perceptions and treatment of moderate/severe dry eye.
The online survey was conducted among 245 U.S. ophthalmologists, including 51 corneal specialists, October 9-21, 2008. A total of 7,882 ophthalmologists were randomly sampled from a list representing virtually all U.S. ophthalmologists (Ophthalmology Times subscribers). In addition, a supplemental sample of corneal specialists was identified through list vendor Direct Medical Data. Those who treated 4 or more moderate to severe dry eye patients per month were asked to complete the survey. This is a response rate of 3.1%, typical for an online survey response. A survey sample of this size has a 95% confidence interval of + 6%. The perceptions of survey respondents were elicited using objective survey items, including multiple choice questions, ranking items and Likert scales. Frequencies, means and medians were calculated and the responses of general/comprehensive ophthalmologists were compared with those of corneal specialists.
94% of respondents agreed that more treatment options are needed for moderate/severe dry eye. Corneal specialists were more likely to strongly agree (63%) than general ophthalmologists (54%). Only 33% overall felt current therapies were extremely or very effective for moderate dry eye, and only 5% for severe dry eye. 92% agreed that multiple therapeutic agents are needed to manage moderate/severe dry eye. Corneal specialists were more likely to strongly agree (49%) than general ophthalmologists (40%). The respondents reported prescribing, recommending or suggesting a mean of 3.2 different treatment approaches over the course of a year for moderate dry eye patients and 4.9 for severe dry eye patients. The most highly ranked goals in treatment of moderate to severe dry eye patients were maintaining and protecting the ocular surface (ranked #1 or #2 by 74%) and lubricating and hydrating the ocular surface (ranked #1 or #2 by 67%). Corneal specialists ranked maintaining and protecting the ocular surface even more highly (ranked #1 or #2 by 82%).
Results reflect the difficulty of treating these more serious moderate to severe cases, the importance of using multiple treatment approaches and the limitations of current treatment options.
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