Expert Perspectives on the Prescription Practice and Management Strategies for Dry Eye Disease in Indian Settings

Abstract

Background: Artificial tears have been recognized as the first-line treatment for dry eye disease (DED), however, the clinician’s opinion regarding the management of dry eye remains uncertain. This study evaluated the Ophthalmologist’s perspectives on the treatment for DED, with a special focus on polyethylene glycol + propylene glycol (PEG + PG) and Lifitegrast in Indian settings. Methods: The cross-sectional study was conducted using a multiple-response questionnaire distributed electronically to clinicians. It included 30 questions on prevalence, demographics, diagnostic practices, treatment strategies, patient education, treatment adherence pertaining to DED, and the perceived benefits of newer treatments like PEG + PG and Lifitegrast. Data analysis was performed using descriptive statistics. Results: This study involved 350 clinicians and revealed that 57.43% preferred PEG + PG eye drops as the first-line treatment for lipid-deficient dry eyes. Approximately 44% recommended PEG + PG thrice daily for mild cases and 53% reported switching to PEG + PG for patients unresponsive to carboxymethyl cellulose (CMC) 0.5%. Additionally, 65% preferred using PEG + PG for moderate symptoms. Lifitegrast was considered effective by 79.43% for targeting LFA-1/ICAM-1 and reducing ocular inflammation. About 61% believed that Lifitegrast provides significant benefits due to its inhibition of T cell adhesion, with noticeable effects within two weeks. According to 80% of the survey participants, compared to traditional lubricants, Lifitegrast offers longer-lasting relief, targeted action, and reduced application frequency. Furthermore, 78% noted the advantages of Lifitegrast over cyclosporine, such as faster relief, no burning sensation, no refrigeration, fewer side effects, and no drug interactions. Conclusion: The survey highlighted PEG + PG combination eye drops as the preferred primary treatment for lipid-deficient dry eyes. Lifitegrast effectively targets LFA-1/ICAM-1, offering rapid relief with minimal side effects, and outperforms traditional lubricants and cyclosporine. These findings underscore Lifitegrast as a key therapeutic option for managing DED.