dEDS

DEDs, or dry eye diseases, describe a group of ocular surface disorders characterized by tear film instability, hyperosmolarity, and inflammation that can cause discomfort and fluctuating vision. These conditions range from mild irritation to significant disruption of daily activities, and they are among the most common eye complaints reported by adults.

Two main categories are commonly used: aqueous-deficient dry eye, where tear production is reduced, and evaporative dry eye, where tear evaporation is increased. Evaporative dry eye is often driven by meibomian gland dysfunction (MGD), which disrupts the lipid layer of the tear film. Other contributing factors include aging, hormonal changes, autoimmune diseases such as Sjögren’s syndrome, medications with dry-eye side effects, environmental conditions (dry air, wind), contact lens wear, and extensive screen use.

Symptoms frequently reported include a gritty or burning sensation, foreign-body feeling, intermittent blurred vision, redness, and light sensitivity. Symptoms can be worse at the end of the day or in dry environments.

Diagnosis involves a combination of patient history and clinical tests, such as tear film break-up time, Schirmer tests to measure tear production, ocular surface staining with dyes, and assessment of meibomian gland function. Tear osmolarity is used in some settings to support the diagnosis.

Treatment aims to relieve symptoms and treat underlying causes. Approaches range from conservative measures (preservative-free artificial tears, eyelid hygiene, warm compresses, humidification, reducing screen time) to prescription therapies (topical anti-inflammatory drops such as cyclosporine or lifitegrast), oral omega-3s, and procedures to restore tear film or preserve tears (punctal occlusion, in-office therapies for MGD, and, in selected cases, lipid-based therapies). Etiology and severity drive management, and DEDs are generally chronic but manageable with ongoing care.