Article

Understanding dry eye disease

Research into the etiology of dry eye syndrome has painted a picture of a highly complex disease that has evolved over the decades. Exhaustive efforts have been expended on shedding light on the mechanisms of dry eye disease. Nevertheless, as more is learned, more questions arise.

Key Points

Debate about the causes of dry eye began in the 1940s with Dr. Henrik Sjögren suggesting a force was pulling water across the ocular surface. The importance of tear film osmolarity later leapt to the forefront as a factor in the rates of tear production and tear film evaporation, which was supported by subsequent observations that upheld the role of tear film osmolarity in dry eye. The theory that inflammation caused dry eye entered the debate, but was negated early on and did not resurface for decades. In the 1980s, Jeffrey Gilbard, MD, R. Linsy Farris, MD, and colleagues reported that dry eye disease is dependent on and proportional to the increase in tear film osmolarity. They said that tear film osmolarity increases as the result of any condition that decreases tear production, including lacrimal gland disease, any condition that decreases corneal sensation, or any condition that increases tear film evaporation, including enlarged palpebral fissure widths or meibomian gland dysfunction.

Study group

Creation of the Dysfunctional Tear Syndrome Study Group was an early effort by dry eye clinicians to develop a plan to diagnose and treat patients with dry eye. The consensus panel comprised 17 international authorities who met in the fall of 2003 at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore.

Newsletter

Don’t miss out—get Ophthalmology Times updates on the latest clinical advancements and expert interviews, straight to your inbox.

Related Videos
(Image credit: Ophthalmology Times)  ASCRS 2025: Joaquin De Rojas, MD, leverages machine learning model to predict arcuate outcomes
(Image credit: Ophthalmology Times) ASCRS 2025: AnnMarie Hipsley, DPT, PhD, presents VESA for biomechanical simulation of presbyopia progression
Shehzad Batliwala, DO, aka Dr. Shehz, discussed humanitarian ophthalmology and performing refractive surgery in low-resource, high-risk areas at the ASCRS Foundation Symposium.
(Image credit: Ophthalmology Times) ASCRS 2025: Advancing vitreous care with Inder Paul Singh, MD
(Image credit: Ophthalmology Times) The Residency Report: Study provides new insights into USH2A target end points
Lisa Nijm, MD, says preoperative osmolarity testing can manage patient expectations and improve surgical results at the 2025 ASCRS annual meeting
At the 2025 ASCRS Annual Meeting, Weijie Violet Lin, MD, ABO, shares highlights from a 5-year review of cross-linking complications
Maanasa Indaram, MD, is the medical director of the pediatric ophthalmology and adult strabismus division at University of California San Francisco, and spoke about corneal crosslinking (CXL) at the 2025 ASCRS annual meeting
(Image credit: Ophthalmology Times) ASCRS 2025: Taylor Strange, DO, assesses early visual outcomes with femto-created arcuate incisions in premium IOL cases
(Image credit: Ophthalmology Times) ASCRS 2025: Neda Shamie, MD, shares her early clinical experience with the Unity VCS system
© 2025 MJH Life Sciences

All rights reserved.