Milner Mark S, Beckman Kenneth A, Luchs Jodi I, Allen Quentin B, Awdeh Richard M, Berdahl John, Boland Thomas S, Buznego Carlos, Gira Joseph P, Goldberg Damien F, Goldman David, Goyal Raj K, Jackson Mitchell A, Katz James, Kim Terry, Majmudar Parag A, Malhotra Ranjan P, McDonald Marguerite B, Rajpal Rajesh K, Raviv Tal, Rowen Sheri, Shamie Neda, Solomon Jonathan D, Stonecipher Karl, Tauber Shachar, Trattler William, Walter Keith A, Waring George O, Weinstock Robert J, Wiley William F, Yeu Elizabeth
aYale University School of Medicine, New Haven bThe Eye Center of Southern Connecticut, Hamden, Connecticut cOhio State University, Columbus dComprehensive Eye Care of Central Ohio, Westerville, Ohio eHofstra Northwell School of Medicine, Hempstead fSouth Shore Eye Care, Wantagh, New York gFlorida Vision Institute, Jupiter hBascom Palmer Eye Institute, Florida International University, and Center for Excellence in Eye Care, Miami, Florida iVance Thompson Vision, Sioux Falls, South Dakota jNortheastern Eye Institute, Scranton kCommonwealth Medical College, Scranton, Pennsylvania lOphthalmology Consultants, St. Louis, Missouri mJules Stein Eye Institute, Los Angeles nWolstan & Goldberg Eye Associates, Torrance, California oPalm Beach Gardens, Florida pRush University Medical Center, Chicago qChicago Eye Specialists rUniversity of Chicago Hospitals, Chicago sJacksoneye, Lake Villa tMidwest Center for Sight, Des Plaines, Illinois uDuke Eye Center, Durham, North Carolina vChicago Cornea Consultants, Ltd, Hoffman Estates, Illinois wWashington University Department of Ophthalmology and Ophthalmology Associates, St. Louis, Missouri xNYU Langone Medical Center, New York, New York yTulane University School of Medicine, New Orleans, Louisiana zOphthalmic Consultants of Long Island, Lynbrook, New York aaThe Center for Ocular Surface Excellence of New Jersey, Woodland Park, New Jersey bbGeorgetown University Medical Center, George Washington University Medical Center, Washington, DC ccNew York Eye and Ear Infirmary of Mount Sinai and Eye Center of New York, New York, New York ddNVision EyeCenters of Newport Beach, Newport Beach, California eeUniversity of Maryland, Baltimore, Maryland ffAdvanced Vision Care, Century City, California ggKeck School of Medicine, University of Southern California, Los Angeles hhBowie Vision Institute, Bowie, Maryland iiUniversity of North Carolina and TLC Laser Eye Centers, Greensboro, North Carolina jjMercy Eye Specialists, Springfield, Missouri kkWake Forest University, Winston-Salem, North Carolina llStorm Eye Institute and Magill Vision Center, Medical University of South Carolina, Charleston mmClemson University, Mt. Pleasant, South Carolina nnUniversity of South Florida, Tampa ooThe Eye Institute of West Florida, Largo, Florida ppCleveland Eye Clinic, Clear Choice Custom LASIK Center, Brecksville, Ohio qqEastern Virginia Medical School and Virginia Eye Consultants, Norfolk, Virginia, USA *Mark S. Milner, Kenneth A. Beckman, and Jodi I. Luchs are co-chairs.
Curr Opin Ophthalmol. 2017 Jan;27 Suppl 1(Suppl 1):3-47. doi: 10.1097/01.icu.0000512373.81749.b7.
Dysfunctional tear syndrome (DTS) is a common and complex condition affecting the ocular surface. The health and normal functioning of the ocular surface is dependent on a stable and sufficient tear film. Clinician awareness of conditions affecting the ocular surface has increased in recent years because of expanded research and the publication of diagnosis and treatment guidelines pertaining to disorders resulting in DTS, including the Delphi panel treatment recommendations for DTS (2006), the International Dry Eye Workshop (DEWS) (2007), the Meibomian Gland Dysfunction (MGD) Workshop (2011), and the updated Preferred Practice Pattern guidelines from the American Academy of Ophthalmology pertaining to dry eye and blepharitis (2013). Since the publication of the existing guidelines, new diagnostic techniques and treatment options that provide an opportunity for better management of patients have become available. Clinicians are now able to access a wealth of information that can help them obtain a differential diagnosis and treatment approach for patients presenting with DTS. This review provides a practical and directed approach to the diagnosis and treatment of patients with DTS, emphasizing treatment that is tailored to the specific disease subtype as well as the severity of the condition.
功能失调性泪液综合征（DTS）是一种影响眼表的常见且复杂的病症。眼表的健康和正常功能依赖于稳定且充足的泪膜。近年来，由于研究的扩展以及有关导致DTS的病症的诊断和治疗指南的发布，临床医生对影响眼表病症的认识有所提高，这些指南包括DTS的德尔菲小组治疗建议（2006年）、国际干眼研讨会（DEWS）（2007年）、睑板腺功能障碍（MGD）研讨会（2011年）以及美国眼科学会更新的关于干眼和睑缘炎的首选实践模式指南（2013年）。自现有指南发布以来，出现了新的诊断技术和治疗选择，为更好地管理患者提供了机会。临床医生现在能够获取大量信息，这些信息有助于他们对患有DTS的患者进行鉴别诊断并制定治疗方案。本综述提供了一种实用且有针对性的方法来诊断和治疗DTS患者，强调针对特定疾病亚型以及病情严重程度进行个性化治疗。
