Review Article

Pathophysiology of dry eye disease and novel therapeutic agents

Solani D. Mathebula, Lerato Mmusi-Landela
African Vision and Eye Health | Vol 83, No 1 | a874 | DOI: | © 2024 Solani D. Mathebula, Lerato Mmusi-Landela | This work is licensed under CC Attribution 4.0
Submitted: 15 August 2023 | Published: 12 June 2024

About the author(s)

Solani D. Mathebula, Department of Optometry, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
Lerato Mmusi-Landela, Department of Optometry, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa


Background: Dry eye disease (DED) is one of the most common ocular surface diseases, which is caused by decreased tear production or increased evaporation. It is a growing public health concern as it influences the quality of life and work and visual function.

Aim: This review will update health care professionals about some of the latest research concerning DED and its treatment.

Method: An extensive literature search was conducted on studies that investigated the aetiology, pathophysiology and treatment options of DED.

Results: The search returned 51 articles that were included in this review. All reviewed papers showed that DED is characterised by the loss of homeostasis, resulting in tear film instability, hyperosmolarity and inflammation of the ocular surface.

Conclusion: The causes of DED are complicated and multifactorial but currently, inflammation of the ocular surface is believed to be the main cause. The many different potential topical and systemic treatments have evolved to provide a targeted and effective treatment option from which clinicians can choose. Most of the potential new drugs have been designed to control inflammation and restore the usual or normal quantity of tears.

Contribution: The goal of treatment should be to improve the patient’s symptoms and/or may be even the signs if present, and a good relationship between the patient and doctor is crucial for the management plan.


dry eye; DEWS; homeostasis; health-related quality of life; ocular surface; hyperosmolarity; inflammation; tear film instability

Sustainable Development Goal

Goal 3: Good health and well-being


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