Translating Biomarker Discovery: From Bench to Bedside in Dry Eye Disease

Dry Eye Disease (DED) is a complex, multifaceted ocular disease characterized by tear film instability and inflammation. It can sometimes be elusive to identify the type of DED in patients, given the overlapping symptoms with other conditions like allergies and the multitude of stimuli that might trigger DED onset. There is also difficulty due to limitations on the diagnostic testing available to clinicians, as poor reliability and a lack of standardization plague accurate diagnoses. Identified biomarkers can help identify DED pathophysiology and category, and these include molecular biomarkers like matrix metalloproteinase-9 (MMP-9), cytokines, lactotransferrin, and lacritin, as well as functional biomarkers such as tear osmolarity. Diagnostic tools, such as the InflammaDry and I-Pen Tear Osmolarity System, also now allow for point-of-care measurement of select biomarkers, including MMP-9 and osmolarity. Nonetheless, there remains a critical need for additional, reliable, and accurate diagnostic devices to better aid in the diagnosis and management of DED. This review uniquely combines a review on the current understanding of various biomarkers with an overview of the emerging technologies available to healthcare providers, aiding in better-informed diagnosis and treatment of DED.