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The aim of this article is to review the literature on the impact of coronavirus disease 2019 (COVID-19) on dry eye disease (DED). A literature search on dry eye and COVID-19 was performed. Most current studies focus on DED in patients diagnosed with COVID-19 or dry eye symptoms in random populations of students and medical staff. Real-world dry eye practices revealed a variety of responses, possibly related to local environmental factors and lifestyle. Patients recovered from COVID-19 warrant ocular surface surveillance for DED. Pandemic mitigation strategies including remote work/school/leisure and mask wearing affect dry eye practices globally. Heightened reiteration of dry eye management for environmental and behavioral modifications, visual display terminals, and mask wearing with attention to its effects on the ocular surface is increasingly important as this pandemic continues.

Purpose: Dry eye disease (DED) is a common disorder that negatively impacts quality of life and vision. Prior studies have shown some benefit of acupuncture for dry eye, but very few have included control group to mitigate placebo effect. This study was designed with a sham acupuncture control group to evaluate true acupuncture treatment effect. Methods: This is a prospective, randomized, double-blinded, sham-acupuncture-controlled trial. Acupuncture treatment for dry eye was performed as per the Niemtzow Protocol. Twenty-four patients received true acupuncture and twenty-five received sham acupuncture. Treatment efficacy was assessed by the Ocular Surface Disease Index (OSDI) Questionnaire, ocular surface staining, tear flow, tear film break-up time (TBUT), and a general questionnaire. Atmospheric data were collected to control for the effect of atmospheric conditions on symptoms of dry eye. Results: OSDI scores in the treatment group improved compared to baseline (1 week, p

Contact lenses, when worn and cared for properly, are a safe and effective form of vision correction used by an estimated 45 million Americans. However, contact lens wearers are at risk for contact lens-related eye infections, especially when wearers do not practice proper contact lens wear and care habits. These infections, affecting the cornea and known as microbial keratitis (Figure), can lead to serious adverse health outcomes. Because contact lenses are regulated by the Food and Drug Administration (FDA) as medical devices, contact lens-related corneal infections should be reported to FDA as an adverse event. To illustrate their serious health implications, six cases of contact lens-related corneal infection, in which sleeping in lenses was reported as the main risk factor, are presented. Consequences of infection reported among the identified cases included the need for frequent administration of antibiotic eye drops, multiple follow-up medical appointments, and permanent eye damage. Health education measures directed toward contact lens wearers should emphasize raising awareness of the risks of sleeping in contact lenses as well as adherence to all recommendations for the wear and care of contact lenses. Additional measures are needed to educate eye care professionals about the need to report contact lens-related corneal infections to MedWatch, the FDA Safety Information and Adverse Event Reporting program (https://www.fda.gov/MedWatch/).

We review the evolution of contact lenses, risk factors for contact lens-related infectious keratitis, and updates on management. Infectious keratitis is still a devastating complication of contact lens use, with improper lens hygiene and use as significant risk factors. Cosmetic contact lenses have become popular among the younger generations. They can be obtained online without a doctor’s prescription or supervision, leading to an increased risk of serious infection. Topical antibiotics remain the best treatment for bacterial keratitis, but resistance to fourth-generation fluoroquinolones has increased. Fungal ulcers fare worse than bacterial ulcers, with no new commercially available topical treatments since topical natamycin. Despite the well-established link between water exposure of contact lenses and development of Acanthamoeba keratitis, patients still regularly expose their lenses to tap water. Corneal cross-linking, new methods for antimicrobial drug delivery, and novel antimicrobial targets represent the next frontiers in the treatment of infectious keratitis. Contact lens-related infectious keratitis remains a serious cause of ocular morbidity, with the rates of atypical causative organisms (Acanthamoeba and fungus) on the rise. Strategies for risk reduction include prevention through patient education; collaboration with industry to develop novel antimicrobials, lens materials, and care system products; and reporting of infections and illegal sale of contact lenses to regulatory agencies such as the United States Food and Drug Administration (FDA) and the Federal Trade Commission (FTC).

This article reviews the literature and summarizes the role of inflammation in dry eye disease. A PubMed search was performed using the keywords inflammatory cycle and dry eye. All searches were limited to articles published in or translated into the English language, dating from 1973 through March 2017. There were no restrictions on the study design. Advances in understanding the pathogenesis of dry eye disease has revealed that inflammation is a core driver: the so-called "vicious circle" of inflammation. Researchers continue to analyze the precise mechanisms by which inflammation occurs. This has led to therapeutic options to break the cycle. Continued animal and human studies reveal other potential sites for treatment in this complex host of disorders.

To review the literature on the efficacy of cyclosporine (CsA) ophthalmic emulsion 0.05% on symptomatic relief in chronic dry eye disease. There is consistent evidence of objective improvements in chronic dry eye disease (Schirmer score, corneal and interpalpebral dye staining, and tear breakup time) with CsA, but variable results with symptomatic improvement, possibly due to patient tolerance of CsA, similar comforting effect with artificial tears and CsA vehicle, and the inherent subjective nature of symptom monitoring and analysis. This review explores the literature on CsA with special attention to symptomatic relief.