{
  "abstract": "Dry eye disease (DED) is a multifactorial condition affecting up to 14.4% of all adults, with symptoms ranging from ocular discomfort to visual disturbances. 1 Despite its complexity, treatment frequently defaults to the use of lubricating drops, commonly referred to as artificial tears, without addressing the many underlying associations and causes. Some of these may be preventable or modifiable, including vitamin D deficiency,2 dyslipidaemia,3 4 environmental triggers5 and medication side effects, while others, such as autoimmune diseases, necessitate alternative forms of treatment.6 The variable cytotoxicity of the essential components of lubricating drops is often not realised, which may lead to a cycle of damage and more intensive lubricating drop usage.7–9",
  "authors": [
    {
      "affiliations": [
        "Cornea and External Diseases, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK",
        "The University of Sydney Save Sight Institute, Sydney, New South Wales, Australia"
      ],
      "name": "Jack Ao"
    },
    {
      "affiliations": [
        "Academic Unit of Ophthalmology, University of Birmingham, Birmingham, UK",
        "SWBH NHS Trust, Birmingham and Midland Eye Centre, Birmingham, UK"
      ],
      "name": "Saaeha Rauz"
    },
    {
      "affiliations": [
        "Bascom Palmer Eye Institute Mary and Edward Norton Library of Ophthalmology, Miami, Florida, USA"
      ],
      "name": "Anat Galor"
    },
    {
      "affiliations": [
        "Eye and Vision Science, University of Liverpool, Liverpool, UK"
      ],
      "name": "Stephen B Kaye"
    }
  ],
  "title": "Dual crisis: environmental and economic unsustainability in NHS dry eye prescribing",
  "uid": "803dd214-74ee-5d60-8fbf-6aa853a03176"
}