Editorial Debate, Discussion, or Dialogue ost of us have witnessed debate, two sides arguing their points with an often escalating combative nature of the interaction. Discussion, on the other hand, is often debate clothed in niceness. In many areas of controversy, such as the existence of polar lipids in the tear film lipid layer, dialogue is needed. Dialogue isn’t concerned with winning or losing, but looks toward deeper understanding and works toward developing a collective point of view. In dialogue, we pursue and explore issues, listening to each other in the pursuit of truth. The Ocular Surface does not often publish comments on or responses to published articles, but in view of the controversy surrounding the presence or absence of polar lipids in the tear lipid layer, we have included a letter from Georgiev concerning the article by Pucker and Haworth1 along with a response from the authors. Both authors engaged in dialogue. I am sure the controversy will continue, and I encourage us all to engage in dialogue around the issue. In the Sources in Time section, Professor Murube provides a detailed review of Demodex, that little mite that we try to attribute much lid disease to. In Pipeline, Dr. Novack provides insight into the funding of new therapies for ocular surface disease. Debate continues about how governmental funding of research actually contributes to the development and commercial success of new products. Our dialogue should center around the better understanding of the impact of ocular surface disease on our patients and the basic science needed to develop novel therapeutics. Speaking of therapies, this issue contains reviews on the use of growth hormone in treating epithelial defects (Wirostko et al), topical cyclosporine A in the treatment of dry eye (Wan et al), and an original research article on the use of autologous serum tears to treat photoallodynia in patients with corneal neuropathy (Aggarwal et al). The latter article should generate further dialogue on our approach to treating patients with neuropathic ocular type pain who are poorly responsive to conventional types of interventions. I remember being awed by the first image of a CT scan of the brain almost 40 years ago. It was a black-and-white Polaroid photo and even with its poor resolution (10 mm slices) it eliminated the need for pneumoencephalograms. I was in similar awe when I saw the first optical coherence tomography (OCT) images of the eye. In both Laboratory Science (Petroll and Robertson) and Innovative Techniques and Technology (Nanji et al), we gain insight into the instrumentation, acquisition techniques, quantitative analysis procedures, and use of OCT in corneal and ocular surface conditions. Tribology deals with friction, lubrication, and wear. The word comes from the Greek root tribo (“I rub”) and logia (“study of“). A Special Article by Pult et al reviews the role of friction in contact lens wear and in dry eye as it relates to tear film viscosity and blinking. Friction may, indeed, play a significant role in patient comfort. More dialogue needed. All in all, a very interesting issue and good reading that should generate plenty of dialogue among us “tritospecialists.”2

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J. Daniel Nelson, MD, FACS Edior-in-Chief REFERENCES 1. Pucker AD, Haworth KM. The presence and significance of polar meibum and tear lipids. Ocul Surf 2015;13(1):26-42 2. Murube J. Evolution of medicine and proto-, deutero- and trito-specialities. Ocul Surf 2015;13(2):95-102

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