Patient with episodic severe nighttime eye pain, morning eye redness and burning
Episodic nighttime eye pain, along with morning redness and burning, could be consistent with blepharitis, a chronic and common inflammatory condition that typically occurs in middle-aged patients and is frequently associated with recurrent corneal epithelial erosion. Other possibilities include lagopthalmos and recurrent corneal epithelial erosion from other causes, such as epithelial basement membrane disease. It is important to make a determination of the primary cause of pain and discomfort and to treat it accordingly.

In addition to causing significant discomfort, blepharitis may be associated with numerous consequences related to ocular surface inflammation, including keratitis, recurrent corneal epithelial erosions, conjunctivitis, and tear dysfunction. It may also aggravate comorbid conditions such as dry eye syndrome and allergies. In severe cases, visual impairment — including haze, ulceration, and perforation of the cornea — may result.

Upon completion of this interactive case, participants should be able to:
• Weigh the risks and benefits of currently approved and late-stage pipeline agents used for the treatment of dry eye, and construct models to help improve patient care based on the potential role of these agents;
• Evaluate the importance of treating dry eye both prior to and after cataract and refractive surgery;
• Develop strategies to better monitor patient adherence to prescribed treatment regimens for the management of dry eye.
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Patient with meibomian gland dysfunction
A cluster of symptoms such as episodic eye pain at night, morning redness and burning, and variable visual acuity in the morning are characteristic signs of meibomian gland dysfunction (MGD, also known as posterior blepharitis). The overlap between symptoms of MGD and those of dry eye syndrome (DES) point to the complex relationship between tear dysfunction and blepharitis.

Upon completion of this interactive case, participants should be able to:
• Weigh the risks and benefits of currently approved and late-stage pipeline agents used for the treatment of dry eye, and construct models to help improve patient care based on the potential role of these agents;
• Discuss the importance of monitoring treatment to prescribed treatments for dry eye;
• Develop strategies to better monitor patient adherence to prescribed treatment regimens for the management of dry eye.
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