Effective Management of Dry Eye Disease in Routine Clinical Practice

Are you in routine eyecare practice and interested in undertaking a practice-based part time (over up to 6 years) PhD focused on improving the management of patients with dry eye disease? A full PhD fee waiver will be awarded to successful candidates and the research can be conducted largely remotely.

Studies demonstrate that about one in three adults [1-3] and one in five children [4] meet the diagnostic criteria for dry eye disease, hence it is commonly encountered in routine primary eye care. The recent TFOS DEWS III report has updated the definition, diagnostic algorithm, identification of pathophysiological drivers and evidence-based management of dry eye disease [5-7]. However, surveys indicate a wide variety of tests that eye care practitioners report are critical for the diagnosis and classification of dry eye disease which do not match an evidence-based approach [8-14]. These tests would take too long to conduct in a routine primary care appointment, so the best method to identify patients with dry eye within the confines of clinical practice and how much treatment targeting can be performed without a full dry eye and ocular surface workup remains unclear.

This project will:

•           Review current guidance on the diagnosis and management of dry eye in primary care including by non-eyecare professionals such as pharmacists and general practitioners

•           Audit current practice relating to patients attending primary eyecare clinics for establishing and managing dry eye disease

•           Trial new approaches to standardise establishing and managing dry eye disease in primary eye care

Please note: The practice will need to cover standard clinical consumables such as fluorescein and lissamine green dyes.

References

[1]        Cai Y, Wei J, Zhou J, Zou W. Prevalence and Incidence of Dry Eye Disease in Asia: A Systematic Review and Meta-Analysis. Ophthalmic Research 2022;65(6):647-58. https://doi.org/10.1159/000525696.

[2]        García-Marqués JV, Talens-Estarelles C, García-Lázaro S, Wolffsohn JS, Cerviño A. Systemic, environmental and lifestyle risk factors for dry eye disease in a mediterranean caucasian population. Contact Lens and Anterior Eye 2022;45(5):101539. https://doi.org/https://doi.org/10.1016/j.clae.2021.101539.

[3]        Vidal-Rohr M, Craig JP, Davies LN, Wolffsohn JS. The epidemiology of dry eye disease in the UK: The Aston dry eye study. Contact Lens Anterior Eye 2023;46(3):101837. https://doi.org/10.1016/j.clae.2023.101837.

[4]        Stapleton F, Velez FG, Lau C, Wolffsohn JS. Dry eye disease in the young: A narrative review. The ocular surface 2024;31:11-20. https://doi.org/10.1016/j.jtos.2023.12.001.

[5]        Jones L, Craig JP, Markoulli M, Karpecki P, Akpek EK, Basu S, et al. TFOS DEWS III: Management and Therapy. American journal of ophthalmology 2025;279:289-386. https://doi.org/10.1016/j.ajo.2025.05.039.

[6]        Stapleton F, Argüeso P, Asbell P, Azar D, Bosworth C, Chen W, et al. TFOS DEWS III: Digest. American journal of ophthalmology 2025;279:451-553. https://doi.org/10.1016/j.ajo.2025.05.040.

[7]        Wolffsohn JS, Benítez-Del-Castillo JM, Loya-Garcia D, Inomata T, Iyer G, Liang L, et al. TFOS DEWS III: Diagnostic Methodology. American journal of ophthalmology 2025;279:387-450. https://doi.org/10.1016/j.ajo.2025.05.033.

[8]        Turner AW, Layton CJ, Bron AJ. Survey of eye practitioners' attitudes towards diagnostic tests and therapies for dry eye disease. Clin Experiment Ophthalmol 2005;33(4):351-5. https://doi.org/10.1111/j.1442-9071.2005.01026.x.

[9]        Graham JE, McGilligan VE, Berrar D, Leccisotti A, Moore JE, Bron AJ, et al. Attitudes towards diagnostic tests and therapies for dry eye disease. Ophthalmic Res 2010;43(1):11-7. https://doi.org/10.1159/000246573.

[10]      Cardona G, Seres C, Quevedo L, Auge M. Knowledge and use of tear film evaluation tests by spanish practitioners. Optom Vis Sci 2011;88(9):1106-11. https://doi.org/10.1097/OPX.0b013e3182231b1a.

[11]      Downie LE, Keller PR, Vingrys AJ. An evidence-based analysis of Australian optometrists' dry eye practices. Optom Vis Sci 2013;90(12):1385-95. https://doi.org/10.1097/OPX.0000000000000087.

[12]      Williamson JF, Huynh K, Weaver MA, Davis RM. Perceptions of Dry Eye Disease Management in Current Clinical Practice. Eye Contact Lens-Sci Clin Pra 2014;40(2):111-5. https://doi.org/10.1097/icl.0000000000000020.

[13]      Wolffsohn JS, Huarte ST, Jones L, Craig JP, Wang MTM, Ambassadors T. Clinical practice patterns in the management of dry eye disease: A TFOS international survey. The ocular surface 2021;21:78-86. https://doi.org/10.1016/j.jtos.2021.04.011.

[14]      Casemore RK, Wolffsohn JS, Dutta D. Dry eye clinical practice patterns of UK optometrists. Cont Lens Anterior Eye 2023;46(5):101889. https://doi.org/10.1016/j.clae.2023.101889.

Candidates should have been awarded, or expect to achieve, EITHER:

a] a First or Upper Second Class award in their Undergraduate Degree (Bachelors or UG Masters) from a UK institution, in a subject judged by Aston to be relevant to the proposed research.

OR

b] a Merit (or above)* in a Postgraduate Masters degree in a relevant subject AND an Undergraduate Degree (Bachelors or UG Masters), both from UK institutions.

*where appropriate.

Qualifications from overseas institutions will be also considered but performance must be equivalent to that described above, and the University reserves the right to ascertain this equivalence according to its own criteria.

Financial Support

This project covers the Home tuition fees. Candidates who do not have Home status will be responsible for the difference in tuition fees. Currently, the difference between ‘Home’ and the ‘Overseas’ tuition fees is £17,712 for 2026/7.  

Overseas Applicants

Overseas applicants may apply for this studentship but will need to pay the difference between the ‘Home’ and the ‘Overseas’ tuition fees. Currently, the difference between ‘Home’ and the ‘Overseas’ tuition fees is £17,712 for 2026/7. As part of the application, you will be required to confirm that you will provide this additional funding. Please indicate this on the application form in the funding section.
 

Apply through our PhD application form.

When applying:

• For University College, please select Health and Life Sciences
• For Degree Programme, please select Research Health Sciences (including Optometry, Pharmacy, and Psychology Research Areas) and your preferred entry date.

Apply now

If you require further information about the application process please contact the Postgraduate Admissions team at pgr_admissions@aston.ac.uk

Supervisor: Prof James Wolffsohn

Associate Supervisors: Dr Sonia Trave-Huarte and Dr Debarun Dutta

Contact information

For formal enquiries about this project contact Prof James Wolffsohn at j.s.w.wolffsohn@aston.ac.uk

PhD programmes are for those who are seeking to develop greater in-depth knowledge in a specific area. Completing this level of study is about making an original contribution to knowledge, making new discoveries and developing lifelong skills. 

Studying a PhD is great route into academia and industries that are centred on research and innovation. Areas with a demand for very high level and specialised research skills often demand PhDs.

In addition to this specialist knowledge, PhD education will help you to develop a set of valuable transferrable skills. The very nature of studying an intensive research degree will enable you to become a team player, develop problem-solving skills, analytical thinking, and advanced presentation and communication skills.