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Submitted: 2025-01-27
DOI: 10.35119/myjo.v7i1.458
Original Articles
Published: 2025-06-30

Implementation of the dry eye disease framework in Malaysian clinical practice: perspectives from local dry eye experts

Department of Ophthalmology, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Bandar Indera Mahkota, Kuantan, Pahang, Malaysia
Department of Ophthalmology, Hospital Canselor Tuanku Muhriz UKM, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
Department of Ophthalmology and Visual Science, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
diagnosis and treatment dry eye disease guidelines Malaysia

Abstract

Purpose: Diagnosis and management of dry eye disease (DED) differ across clinics due to the variable diagnostic and treatment equipment and the lack of localised guidelines for managing DED. This study aims to understand the current landscape of DED diagnosis and management in the Malaysian healthcare setting, as well as to evaluate the feasibility of implementing a DED framework in local settings.

Study design: A quantitative cross-sectional survey.

Methods: A 12-item multiple-choice questionnaire was administered to 13 local cornea specialists from May to September 2023 via the SurveyMonkey online platform, and the responses were collated and analysed using Microsoft Excel software. The questionnaire comprised of six dimensions: guidelines utilisation for DED diagnosis and management; standardisation for DED diagnosis and management between clinics; administration of validated DED questionnaire to patient; availability of clinical and screening tests in their clinics; treatment availability in their clinics; and follow-up and patient education.

Results: Most respondents (84.6%) use one or more international guidelines or national guidelines from other countries in their clinical practice. All respondents agreed that DED diagnosis and management should be standardised among ophthalmologists, while 92.3% would consider implementing a standardised DED diagnosis and management algorithm in their practice. More than two-thirds of the respondents (69.2%) do not have the resources for their patients to self-administer DED questionnaires. All respondents have slit-lamp examination, fluorescein tear film breakup time test, and corneal fluorescein staining as screening tools, as well
as ocular lubricants, cyclosporine A, and corticosteroids as treatment options in their clinics. Most respondents (92.3%) were able to follow-up with their patients at least every 6 months. Only 38.5% of the respondents were able to allocate time for patient education, with an average of 13 minutes/visit.

Conclusion: This study revealed that most local cornea specialists would consider implementing a standardised DED framework in managing their patients with DED. However, factors impeding its implementation (e.g., diagnostic and treatment equipment availability, cost and clinical workflow differences, and patient loads) in local settings should be identified and tackled to standardise DED management and improve the quality of patient care in Malaysia.