The Tear Film & Ocular Surface Society's DEWS III report draws criticism from a dry eye specialist who argues it's long on pages but short on new insights. Key concerns include a symptom-only diagnostic trigger that may miss asymptomatic DED, the abandonment of the DEWS II severity-based treatment framework, and a lack of clinical evidence supporting foundational recommendations like artificial tears.
The Tear Film & Ocular Surface Society (TFOS) has released its third Dry Eye Workshop (DEWS III) report in the American Journal of Ophthalmology, and not everyone is convinced it moves the needle. Dr. Darrell White, a dry eye specialist at SkyVision Centers in Ohio, offers a pointed critique — arguing that the sprawling document adds complexity without meaningfully advancing clinical practice.
One of his sharpest objections: DEWS III suggests that a single questionnaire (the OSDI-6) with no abnormal answers is sufficient to skip DED testing entirely. White argues this overlooks a well-documented reality — a significant portion of patients have DED with no symptoms, particularly those presenting for surgical consultations. He also questions the report's departure from the DEWS II severity-based treatment algorithm and the absence of cited clinical evidence for recommending artificial tears as a primary treatment.
Key Takeaways:
Why it matters: For eye care providers managing dry eye daily, DEWS III's volume and some of its recommendations may create more confusion than clarity — raising questions about whether large consensus documents are keeping pace with real-world clinical practice.
