Artificial Tears Most Common Initial Therapy for DED

Artificial tears, immunomodulators and steroids were found to be the most common initial therapies for dry eye. MGD treatment may deviate from guidelines, favoring immunomodulators or steroids over lipid-based lubrication, while Sjögren’s management does align with recommendations. Photo: Scott G. Hauswirth, OD. Click image to enlarge. Dry eye disease (DED) management ideally should follow staged guidelines with specific treatment tailored to patient-specific factors. Does it? In a study presented Tuesday at ARVO 2026 in Denver, researchers compared real-world treatment patterns against practice guidelines, aiming to identify gaps that may drive the economic and quality-of-life burden of DED.A total of 300,287 DED patients (mean age 60; 73% female; 68% white) from the TriNetX database were retrospectively analyzed. Therapies included artificial tears, steroids, immunomodulators, ointments, Meibo (perfluorohexyloctane 100%, Bausch + Lomb) and punctal plugs. Patients with recent ocular surgery (≤10 days), infection, inflammation or trauma were excluded. Each treatment line ended after a gap of three or more months.The findings showed that 22% of patients received one or more therapy, and subsequent treatments were most often a repeat of initial therapy. Artificial tears were the most common (37%), but prolonged use of immunomodulators (27%) and steroids (12%) for longer than 80 days was also typical.Of 43,684 meibomian gland dysfunction patients, 22% received one or more treatments. Immunomodulators (28%), steroids (25%) and artificial tears (21%) were the top choices of the doctors who managed these patients. Most common initial therapies were immunomodulators (22%), steroids (21%) and artificial tears (18%). Of second-line treatments, immunomodulators (37%), artificial tears (16%) and steroids (15%) were highly prevalent.Of 65,263 Sjögren syndrome patients, 18% received one or more treatments. Immunomodulators (40%), artificial tears (28%) and steroids (13%) were the top three. The most common first-line treatment was immunomodulators (35%), artificial tears (25%) and steroids (10%), with up to six courses of immunomodulators.The authors wrote that real-world prescribing patterns may not in fact be tailored to DED subtype, highlighting a potential gap between guidelines and practice.Original abstracts ©2026 Association for Research in Vision and Ophthalmology. Click here for the source. Amin R, Haddad E, Sayegh RR. Dry eye disease prescribing patterns: comparing evaporative vs. aqueous-deficient dry eye. ARVO 2026 annual meeting. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.