How has immunomodulation been evaluated in EDED?

• A. In humans, topical cyclosporine decreases ocular surface and meibomian gland inflammation
• B. In dogs, immunomodulation cures MGD
• C. It has not been studied at all
• D. It worsens tear production

Answer: (A)

Immunomodulation in evaporative dry eye disease (EDED) has been most convincingly evaluated in humans, where topical cyclosporine A is used to dampen the immune response on the ocular surface and within the meibomian glands. Cyclosporine acts as a calcineurin inhibitor, reducing T-cell activation and the production of inflammatory cytokines. By curbing this inflammatory cascade, it helps restore tear film stability, reduces ocular surface inflammation, and can improve tear production and meibomian gland function over time. This provides a direct mechanism and clinically meaningful benefit in human EDED.

The other statements don’t fit with current evidence. In dogs, immunomodulation is not established as a cure for meibomian gland dysfunction, and claiming a cure overstates the available data. Saying it hasn’t been studied at all ignores existing human research and some veterinary investigations. And evidence that immunomodulation worsens tear production is not supported by the data.