Dry Eye Research Update in Japan in Celebration of the 25th Anniversary of the Dry Eye Society and the 10th Anniversary of Hakone Dry Eye Club

The Dry Eye Society was founded in 1990, serving this field for more than 25 years. The purpose of the Society is to develop a consensus on the definition and classification of dry eye, promote basic and clinical research, and perform public education on dry eye. Until around 1990, dry eye disease was not well understood by Japanese society. Several diagnostic names such as Sjögren syndrome, aqueous deficiency, and keratoconjunctivitis sicca were used for the disease by many ophthalmologists, but a consensus was absent among researchers. Moreover, around 1990, the symptoms of dry eye were considered as minor, and dry eye was not an established disease category. Since the establishment of our Society, we have dedicated our work to public education, explaining the importance of eye fatigue, irritation, and visual impairment due to dry eye. Through these endeavors, the recognition of dry eye terminology had increased to 73% by 1999—9 years after the establishment of our Society.¹ In 1995, we reported the first definition and diagnostic criteria by our Society.² At that time, the diagnosis could be made without symptoms. The most important components were decreased tear production, and abnormalities on the ocular surface shown by rose bengal or fluorescein staining, or squamous metaplasia. After increasing our understanding on the importance of dry eye symptoms, we revised the definition of dry eye in 2006, in which the symptoms became a mandatory factor for the diagnosis of dry eye.³ Recently, in 2016, we have again revised the definition to include only two components (i.e., subjective symptoms and unstable tear film, which can provide a diagnosis of dry eye).⁴ Since the understanding of dry eye has been changing worldwide over the last 25 years, it is essential that we revise the definition and diagnostic criteria accordingly. As of 2018, our Society has 700 members and the Governing Board consists of 13 officers and 15 council members (in the public domain, http://www.dryeye.ne.jp/en/doctor/index.html). We hold an annual educational seminar in February, and luncheon seminars at meetings held by the Japanese Ophthalmological Society, including the dry eye research award ceremony to recognize the contributions made by the most active dry eye researchers of the year. The list of the past awardees is shown in the Table. 

Table

 

Dry Eye Research Awardees

 

In addition, we established the Hakone Dry Eye Club, which focuses on research and education on dry eye during an annual overnight retreat. Every year, all active dry eye researchers gather and hold in-depth discussions about dry eye, as well as impart current knowledge to the budding dry eye researchers. This annual event has greatly contributed to the consensus on the definition and diagnostic criteria of dry eye, as well as encouraging active research. In addition, we have promoted dry eye research in Asia from 2012 by sponsoring the first Asia Dry Eye Society (ADES) meeting in Tokyo (in the public domain, http://asia-dry-eye.biz/). The ADES is now growing rapidly thanks to the enthusiastic cooperation of China, Korea, and other countries; in addition, we are very active in determining the definition and classification of dry eye, collaborative research, and the exchange of knowledge.⁵ Each autumn, we hold a scientific meeting, and the membership has grown from the founding 3 countries to 11 countries in 2018. 

We are proud of publishing the dry eye research special issue in Investigative Ophthalmology & Visual Science on the occasion of the 25th anniversary of the Japan Dry Eye Society and 10th anniversary of Hakone Dry Eye Club. The contents of this special issue on dry eye by the Dry Eye Society were planned by the editorial committee: Drs Shiro Amano, Jun Shimazaki, Yuichi Hori, Norihiko Yokoi, and Yuichi Uchino. We have selected active dry eye researchers from the Dry Eye Society, defined as those who have published several articles on dry eye as a first or corresponding author. We have chosen 28 researchers to cover seven categories according to their subspecialties. Each article reports on the history and current findings of the subject in Japan and other parts of the world, as well as future directions. We are very proud of the contributions made by our Society to dry eye research worldwide, especially in the area of diagnosis and therapy, including the importance of the measurement of tear film break-up time to the development of mucin-secreting eye drops such as diquafosol sodium or rebamipide. I hope this special issue on dry eye enables dry eye researchers in Asia and worldwide to appreciate the contributions made by the Japanese research community. 

Acknowledgments

Funding of the publication fee and administration was provided by the Dry Eye Society, Tokyo, Japan. The Dry Eye Society had no role in the contents or writing of the manuscript.