Publication Exclusive: Dry eye needs to be evaluated, managed before ocular surgery

Dry eye is a multifactorial disease of the tear film and ocular surface resulting in symptoms of discomfort, visual disturbance and tear film instability with potential ocular surface damage. It is accompanied by increased tear film osmolarity and ocular surface inflammation. This definition, given by the Dry Eye WorkShop in 2007, forms the basis of our understanding of dry eye. It also gives guidelines regarding grading of dry eye and treatment strategies for each grade of severity.When it comes to ocular surgeries, managing dry eye in the perioperative period plays an important role in having a good outcome and a happy patient. Most of the patients that we operate for cataract are elderly with pre-existing minimal dry eye or a component of conjunctivochalasis, both of which can get worse after surgery. Apart from the routine use of a dry eye questionnaire and clinical evaluation with Schirmer’s test, corneal staining and tear breakup assessment to diagnose dry eye, newer modalities of investigations are now being used.