The potential benefits of periorbital transcutaneous electrical stimulation for the management of dry eye disease

Dry eye disease (DED) is among the most frequent pathologies of the ocular surface (OS). As a multifactorial condition, it is appropriate to manage it with strategies that are customized according to patient signs and symptoms. Recently, several studieshave suggestedthat transcutaneous electrical stimulation (TCES) of the periorbital areainduces various benefits for DED patients, including more efficient eye blinking. This application is particularly novel, as few treatments directly address the effect of inefficient blinking on OS health. In this article, this and other potential benefits of TCES applied in the periorbital area, for a better management of DED, are reviewed. The review starts with a general discussion of the uses of TCES in non-ophthalmic fields of medicine, where merits of this approach are widely recognized, and proposed mechanisms of action (MOAs) are supported by experimental evidence. Results of recent studies which suggest that electrotherapy might be useful for addressing DED as well are then summarized. Finally, the relevance of MOAs proposed in other fields of medicine is examined for DED. It is suggested that TCES enhances blinking and supports OS health through neuromuscular, analgesic, and anti-inflammatory pathways. Given its multifaceted benefits, TCES represents a promising addition to the therapeutic toolkit for ocular surface disease (OSD).