Exploring the natural history of dry eye disease development

Monday, 11 March, 2019 - 15:30


Exploring the natural history of dry eye disease development

Time/Date: 3:30pm - 4:30pm Monday 11 March 2019

Location: K-F10-M10 Lecture Theatre Chemical Science Building (M10)


This presentation explores dry eye disease development by comparing the ocular surface and tear film characteristics of the anatomically distinct Asian and Caucasian eye throughout life. Three methodologically homogenous, age and environmentally-controlled, cross-sectional studies comprising Asian and Caucasian populations ranging from 5 to 90 years of age were pooled for analysis.  The earliest ethnic disparities detected were significantly higher degrees of incomplete blinking and lid wiper epitheliopathy in the young Asian eye (under 18 years of age), that may be attributable to the anatomical predisposition towards increased eyelid tension.  These differences persisted in the older age groups and were compounded by an inter-ethnic divergence in the level of meibomian gland dropout in the young adult population and, further, by differences in symptoms, tear film clinical characteristics, meibomian gland function and disease likelihood (based on TFOS DEWS II criteria) in the middle adult population.  Disparities in corneal and conjunctival staining were limited to the older adult population. The results suggest a critical role for blinking in dry eye development through loss of meibomian gland function.  Comparable and physiologically adequate tear meniscus heights noted across all age groups support the clinical observation that an evaporative rather than aqueous deficient mechanism appears to be the major player in the natural history of dry eye development.


Associate Professor Jennifer P Craig,

BSc (Hons), MSc (Cataract & Refractive Surgery), PhD, FCOptom, FAAO, FBCLA, FCCLSA

NZ Registered Optometrist (TPA)

Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, New Zealand

Therapeutic optometrist, Jennifer P. Craig is an Associate Professor in Ophthalmology at the University of Auckland in New Zealand, where she heads the Ocular Surface Laboratory and is Immediate Past Chair of the Optometrist and Dispensing Opticians Board of New Zealand.  Her main research interest is in dry eye and tear film dysfunction. She regularly delivers continuing education and research lectures internationally and publishes in both the scientific and clinical press.  She is co-author of the book ‘The Tear Film’ and has contributed to the TFOS International Workshops on Meibomian Gland Dysfunction and Contact Lens Discomfort and has most recently served as Vice-Chair for the second Tear Film and Ocular Surface Society’s Dry Eye Workshop (TFOS DEWS II) published in 2017.