The most common symptoms associated with DES are ocular irritation, photophobia, blurry vision, mucoid discharge, ocular dryness, itching, and excessive tearing. DES is diagnosed through tests such as the Schirmer test, tear film osmolarity, tear meniscus height, tear ferning test, measurement of tear break up time, and staining of corneal and conjuctivital epithelium with lissamine green and fluorescein or rose bengal.
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Topical anti-inflammatory agents (cyclosporine and corticosteroids), omega 3 fatty acids, immunosuppressant, umbilical cord serum, artificial tear substitutes and gels, emulsions, and ointments are the common agents used for treatment of DES. Advanced options for the treatment of DES include conjunctival flap, mucous membrane grafting, lateral tarsorrhaphy, salivary gland duct transposition, amniotic membrane contact lens therapy, and prosthetic replacement of the ocular surface ecosystem (PROSE) lens therapy.
The global dry eye syndrome treatment market is primarily driven by growing geriatric population coupled with high prevalence of dry eye syndrome and growth in awareness about the diagnosis and treatment of the disease. However, the stringent drug approvals, expirations of the blockbuster drugs patents, and lack of skilled ophthalmologists are restraining the growth of DES market.
According to National Health and Wellness Survey in 2013, approximately 16.4 million people are suffering from DES, which accounts for 6.8% of the total population of the U.S. Prevalence of DES increases with age, 2.7% for 18 - 34 age group and 18.6% for more than 75 age group were reported to be suffering from DES. The prevalence of DES is higher in women (8.8%) as compared to men (4.5%). According to the National Eye Institute, in the U.S the annual cost of treating DES including prescription drugs is US $3.84 billion.
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The two most common types of DES are DES associated with Sjogren syndrome (SS) and DES unassociated with SS. DES can also be classified as aqueous deficiency dry eye and evaporative dry eye disorder. Patients with aqueous tear deficiency (ATD) often suffer from SS if they have shown symptoms of connective tissue disease (CTD) or xerostomia in past. Patients with primary SS showed evidence of autoimmune disease with high presence of ocular surface disease, ATD and serum autoantibodies.
According to TearScience Inc., in 2012, around 86% of the patients in Europe and the U.S. were suffering from DES showed symptoms of Meibomian Gland Dysfunction (MGD, blockage of meibomian glands). The blockage causes less secretion of oil in the tears, which results in evaporation of tears too quickly. Global dry eye syndrome treatment market is oligopolistic in nature with few players holding majority of the share. Various strategies are adopted by market players such as new product launches, acquisitions, and agreements in order to retain market position.
In September, 2017, Johnson and Johnson Vision, acquired TearScience Inc., a medical device manufacturer for treating MGD. This acquisition expanded the company’s eye health portfolio. In April 2017, Allergan received marketing approval from FDA for its TrueTear Intranasal Tear Neurostimulator.
Some of the major players operating in the global dry eye syndrome treatment market are Allergan, Novartis AG., Otsuka Pharmaceutical Co. Ltd., Valent Pharmaceuticals, Johnson and Johnson Vision, Acadia Pharmaceuticals, Allostera Pharma, I-Med Pharma Inc., Santen Pharmaceuticals Co. Ltd., AFT pharmaceuticals, Novaliq GmBh, and Auven therapeutics.
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