Abstract
Dry eye disease (DED) is a multifactorial disease in which the tear film’s homeostasis is lost, along with other ocular symptoms such as tear film instability and high osmolarity, neurosensory abnormalities, and ocular surface inflammation and damage. DED is a condition of lacrimal apparatus which is responsible for tear production. The tear film is a mixture of mucin, aqueous (water and solutes like NacI, sugar, urea, proteins,), lipids secreted by goblet cells, lacrimal glands, and meibomian glands, respectively. It keeps the eye moist, provides oxygen to the cornea, and has antibacterial properties. The lipid layer prevents the evaporation of the aqueous. DED is categorized into (i)Aqueous-tear deficiency, characterized by a deficiency of lacrimal glands to secrete tears, (ii)Evaporative DED, associated with increased tear loss by evaporation because there is a deficiency of the meibomian glands. The mechanism of DED might be loss of tear through evaporation or insufficient aqueous production or a combination of the two. DED is a widespread eye problem, which is often left untreated. It causes irritation, itching, dryness, foreign body sensation, and discomfort; severe case causes conjunctival congestion, keratinization, erosion of the corneal epithelium, and plaque formation. If left Univision- threatening vision-threatening, leading to complications like corneal ulceration and perforation. Various clinical tests are used to diose DED, including tear breakup time, tear osmolarity, Schirmer test, Rose Bengal staining, and expression of inflammatory markers. There is no cure for DED at present. The following modalities are used for its treatment:
 
 use of punctual and canalicular plugs,
 artificial tear products like polyethylene glycol/propylene glycol with guar HP,
 consuming food rich in omega-three fatty acids, antioxidants zeaxanthin, and lutein,
 Use of anti-inflammatory drugs, mucolytics, secretagogues.
 Reducing or avoiding mild risk factors like prolonged reading, prolonged use of contact lenses, excessive screen time, etc.
 Treatment of causative disease.
 
 Appropriate management and establishing reasonable patient expectations are necessary to ensure patient satisfaction and adherence to the treatment.
Highlights
Many people worldwide are affected by Dry Eye Disease (DED)
The drainage starts, and it goes into the lower and upper canaliculi, into the lacrimal sac, and into the nasolacrimal duct, which opens into the inferior meatus of the nose and is guarded by the valve of Hasner
This review talks about tear film, the causes of dry eye, recommended treatments, limitations faced in the current management of the DED, and how to establish reasonable patient confidence towards the management of DED [8]
Summary
Many people worldwide are affected by Dry Eye Disease (DED). DED is a lacrimal apparatus condition that comprises lacrimal glands and lacrimal passages, including puncta, canaliculi, lacrimal sac, and nasolacrimal duct. Accessory glands include the Glands of Krause and Wolfring They are situated in the fornix and are responsible for basal secretions. The drainage starts, and it goes into the lower and upper canaliculi, into the lacrimal sac, and into the nasolacrimal duct, which opens into the inferior meatus of the nose and is guarded by the valve of Hasner. 2. Evaporative DED, associated with increased loss of tears by evaporation due to a deficiency of lipids secreted by the meibomian glands [6]. Most DED (>80%) is a mixed condition in which lacrimal and meibomian glands are deficient [7]. This review talks about tear film, the causes of dry eye, recommended treatments, limitations faced in the current management of the DED, and how to establish reasonable patient confidence towards the management of DED [8]
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