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This large prospective study from the BioDay registry provides robust evidence that ocular surface disease (OSD) is highly prevalent in moderate-to-severe atopic dermatitis (AD) patients even before dupilumab treatment. A significant subset (30.7%) developed dupilumab-associated ocular surface disease (DAOSD) during 28 weeks of therapy, despite increased use of ophthalmic medications. Notably, while conjunctival goblet cell (GC) numbers remained stable, dupilumab was associated with decreased mucin 5AC (MUC5AC) production, a critical component for ocular surface health.
