EyeCon 2025: The latest on treating ocular surface and cornea disease

Rahul Tonk, MD, MBA a cornea, cataract, and refractive surgeon from Princeton Eye Group and faculty at Wills Eye Hospital, shared insights on recent advancements in ocular surface disease (OSD) for the EyeCon 2025 conference in Hollywood, Florida. Tonk and Joseph Allen, OD, FAAO, Dipl ABO, gave their talk "Tour of the Eye -- Stop 1: Treating Ocular Surface/Cornea Disease" during the conference, which ran from September 26-27.

Tonk highlighted 2 significant diagnostic developments:

1. Non-contact aesthesiametry: Helps detect neurotrophic keratitis implications in dry eye patients
2. Non-invasive tear breakup time: Provides better understanding of tear film and lipid layer dynamics

As for treatment advancements, significant progress has been made in both drug and device treatments, including improvements in thermal pulsation, enhanced intense pulsed light (IPL) techniques, and pharmaceutical developments in tear stimulation, anti-inflammatory treatments, and meibomian gland replacements.

Despite technological advances, Dr. Tonk emphasizes the critical importance of comprehensive patient history and detailed clinical examination. Considerations to take in terms of a patient's history include symptom timing (morning, end of day), symptom triggers and alleviators, itching, previous eye drop usage, and medication reactions

For clinical examinations, Tonk recommends:

• Stepping back from the slit lamp
• Observing facial features
• Examining eyelid position
• Assessing body habitus
• Checking for conditions like floppy eyelid disorder

Additionally, many patients have ocular surface disease without recognizing it, often manifesting as fluctuating vision, computer/tablet-related eye fatigue, and misinterpreted as need for vision correction

The overarching message is that a precise diagnosis leads to more effective treatment, and comprehensive patient assessment goes beyond technological tools.