Surgery, environmental factors can trigger dry eye flare-ups


August 27, 2021

1 minute read

Source / Disclosures


Owen D, et al. Rapid assessment of the 10-year evidence of dry eye flare-ups. Presented at: Summer Symposium on Women in Ophthalmology; August 26-29, 2021; Amelia Island, Florida.

Disclosures: Owen says he is director of medical science liaison at Kala Pharmaceuticals. Healio / OSN was unable to confirm relevant financial information for the other authors at the time of publication.

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According to a poster presented at the Women in Ophthalmology Summer Symposium, the fluctuating symptoms of dry eye after surgery or exposure to environmental triggers are “very suggestive” of flare-ups.

A rapid review of the evidence from five refractive surgery studies, five daily life studies, and 12 controlled-environment studies looked at data on short-term exacerbations of symptoms or signs in patients with dry eye after eye surgery or environmental challenges, such as air conditioning, wind, reading, low humidity, and use of digital devices.

“Although none of the included studies specifically used the term ‘DED flare’, the patterns of exacerbation of the reported signs and symptoms were consistent with the definition of dry eye flare-ups.” Desiree Owen, OD, and colleagues said in the presentation.

Of three refractive surgery studies that included the mean time to tear film rupture before and after surgery, one reported statistically significant differences (P P

In studies of daily living, three have used controlled environment chambers to elicit an eye surface response in signs and symptoms of dry eye. In all three studies, matrix metalloproteinase-9 (MMP-9) increased statistically significantly from baseline 2 hours after challenge.

“The rapid increase in MMP-9 expression after exposure indicates that the innate immune response plays a role in DED outbreaks, which may be a suitable biomarker for the assessment of DED outbreaks. The presence of MMP-9 also suggests the need for broad-spectrum anti-inflammatory drugs in the treatment of dry eye flare-ups, ”the authors said.


  • Starr CE, et al. Ocul Surf. 2021; doi: 10.1016 / j.jtos.2021.07.001.

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