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The Landscape and Future of Ocular Rheumatology, with Jacob Lang, OD
Lang discusses his expectations and excitement for upcoming developments in the field and encourages clinicians to work together to better treat complex patients.
At the 2025 American Optometric Association Conference in Minneapolis, MN, Jacob Lang, OD, medical director of dry eye services and director of Associated Eye Care’s ocular disease residency program, presented his lecture on the current landscape of ocular rheumatology.1
Ocular rheumatology encompasses a variety of eye diseases, from simple inflammation to papilledema and uveitis. Recent movements towards a general universal terminology structure, which has streamlined the field significantly and allowed for more rapid advancements in treatments and methodology.2
Lang spoke on the status of the eye as an immune privileged site susceptible to a variety of conditions and interactions, as well as its direct linkage to the immune system.
“As we look at different eye diseases, we’re learning more and more about how inflammation affects the eye,” Lang told HCPLive. “Really, inflammation is the enemy of every eye care doctor. And so, if we’re thinking about treating and managing inflammation as eye doctors, we’re really thinking about it from a systemic perspective, and that’s rheumatology.”
Lang expressed excitement for the future of ocular rheumatology, noting a variety of upcoming drugs which may facilitate more specificity in treatment and targeting.
“We’re seeing that in rheumatology with all the biologics, and eye care is no different,” Lang said. “We’re going to see more tailored therapies, more specific therapies, that’ll treat eye disease in a better, more productive, safer way for our patients. We’re seeing that with biologics and ocular surface disease, we’re seeing that in thyroid disease.”
Lang also noted significant advancements with teprotumumab for thyroid eye disease, a monoclonal antibody that targets insulin-like growth factor 1 receptors to reduce inflammation.
Additionally, Lang spoke on treating inflammation at large and the paradigm shift that he believes is necessary to prioritize what is increasingly appearing as a common ground for various eye diseases.
“Ocular surface disease and eye diseases are anchored in inflammation, and there can be systemic conditions that might be affecting that,” Lang said. “We need to understand holistically how we’re treating these patients and how we can best manage inflammation within the eye.”
In closing, Lang discussed his expectations for the field through the rest of 2025.
“I think there’s a lot of new drugs that’ll be launching this fall; I think we’re seeing more specific medications for our patients,” Lang said. “I’m also really excited about optometry taking a bigger role in integrated care: working as a team to take care of our patients, whether that be with rheumatologists, internal medicine doctors, endocrinologists, the village that it takes to take care of these complex patients.”
Lang reports the following disclosures: Alcon, Aldeyra, Dompe, Horizon, Kala, Novartis, and others.
References
Lang J, McGee S. Ocular Rheumatology; An Anterior Segment Perspective. Presented at the 2025 American Optometric Association Conference in Minneapolis, MN, June 25-28, 2025.
Ragusa E, Salvarani C, Cimino L. Through the eyes of an ocular immunologist: The interdisciplinary ophthalmology-rheumatology approach. Saudi J Ophthalmol. 2025;39(1):1-4. Published 2025 Mar 24. doi:10.4103/sjopt.sjopt_81_25
