Dry-eye--is inflammation just the tip of the iceberg?

Background: Dry eye syndrome (DES) has been described by The International Dry Eye WorkShop as ''multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance and tear instability with potential damage to the ocular surface.'' Inflammation has been recognized as a primary contributor to the disease and was a tremendous step forward in the description and treatment of DES. Although most treatments of DES treat inflammation, the signs and symptoms of DES usually return shortly after discontinuing the use of the anti-inflammatory agent;

Case: We present a case of a 70-year-old patient who presents with significant dry eye symptoms for 2 years. She reports the need to wear sunglasses during all waking hours, both indoors and out, and had discontinued her hobby of gardening. She had ocular rosacea diagnosed at a previous ophthalmology practice and did not respond to any past treatments. The patient was treated with 25% platelet-rich plasma (PRP) and experienced significant improvement and a return to a normal quality of life that has continued for more than a year after discontinuing treatment;

Conclusion: Our group is investigating the use of biologic therapeutics in the treatment of various forms of DES. We suggest that a clinically acceptable dosage of PRP provides the ocular surface with the components necessary to restore normal cellular tensegrity and provides a foundation to eliminate the recurrence of the inflammation associated with DES.