Ocular surgery
Hyaluronic acid in ocular surgery
Dry Eye Disease
Understanding Dry Eye Disease: causes, symptoms, and treatment options
What is Dry Eye Disease?
Dry Eye Disease is a common disorder of the eye surface in which the eyes don’t make enough tears or the tears evaporate too quickly, leading to ocular discomfort and/or visual disturbances.1,2
Signs and symptoms of Dry Eye Disease affect between 5% and 50% of the global population, resulting in significant visual, psychological and physical impact on quality of life, and considerable economic burden due to reduced work productivity.³
What causes dry eye disease
Dry eye disease is a multifactorial condition that can be triggered by various mechanisms. The current scientific consensus identifies three main etiologies of dry eye disease:1
Tear film deficiencies – disruption of any layer of the tear film (lipid, aqueous or mucin layer).
Eyelid anomalies – blink and lid closure anomalies or issues with the lid margin such as blepharitis or Meibomian gland dysfunction (MGD) might lead to the development of dry eye disease.
Ocular surface abnormalities – neural dysfunction or ocular surface cellular damage are also major causes of symptoms.
Causes
Possible causes of Dry Eye Disease include:4,5
- Aging – dry eyes occur naturally with aging as the eyes make fewer tears
- Decreased hormone (androgen) levels – especially in women after the menopause
- Blepharitis – inflammation of the eyelid margin
- Meibomian Gland Gysfunction (MGD) – obstruction of lipid secretion into the tear
- Autoimmune diseases – rheumatoid arthritis, systemic lupus erythematosis, Sjögren’s syndrome
- Stevens-Johnson syndrome – can cause inflammation, conjunctival scarring and block the tear duct (lacrimal glands)
- Medications – including some medicines to treat high blood pressure, allergies, colds, heartburn, anxiety, or depression
- Skin diseases – on or around the eye e.g., rosacea or eczema
- Post-ocular surgery – e.g., after laser eye surgery
- Contact lens use
- Environmental factors – low humidity, pollution, strong winds, cigarette smoke and cooking fumes
- Reduced blinking – when looking at a computer screen, reading or other activities for a prolonged time
Symptoms of Dry Eye Disease
There are many symptoms of Dry Eye Disease, and you may experience all or some of them:5,6
- Itchy eyes or a feeling like there is something gritty in the eye
- A burning or stinging sensation in the eye
- Redness of the eyelids or conjunctiva
- Eye dryness (not always present)
- Blurring or fluctuating vision
- Watery eyes (reflex tearing due to irritation)
- Light sensitivity
- Mucous discharge
- Eye tiredness
- Discomfort during reading, screen time, or contact lens wear
When to talk to a healthcare professional
If you experience any of the symptoms of Dry Eye Disease it’s important you don’t wait until symptoms become severe before you seek help. It’s worth speaking to your pharmacist, doctor or your optometrist, who will be able to advise you and suggest medication such as eye drops depending on what’s causing your dry eye. If this doesn’t solve the problem they may refer you to an eye specialist, known as an ophthalmologist.
Treatment options
Treatment options recommended by your healthcare professional may include:7,8
Lifestyle modifications
To preserve existing tears e.g., reduce screen use, reduce contact lens wear, increase humidity, avoid cigarette smoke
Tear supplements
Use of artificial tears that enhance and/or stabilise the tear film
Tear conservation
Through use of devices such as wrap-around glasses, or punctal plugs that block the tear drainage system.
Our treatment and expertise
For more than 25 years, TRB has been developing expertise in the management of dry eye disease, working closely with eye care professionals to support patients affected by ocular surface disorders.
This long‑standing experience is built around hyaluronic acid technology, a recognised approach to ocular surface hydration and protection. These solutions are designed to hydrate, protect and stabilise the ocular surface, helping to relieve symptoms associated with tear film instability.9
Hyaluronic acid is a naturally occurring polymer that is also present in the structures of the human eye. Its particular physical characteristics confer viscoelastic and water‑retaining properties, making it especially suitable for ocular lubrication.10
Thanks to these properties, hyaluronic acid forms a stable coating on the surface of the eye that is only slowly eliminated by blinking.11
This helps maintain prolonged hydration of the ocular surface while ensuring comfort during blinking. Different concentrations of hyaluronic acid, ranging from 0.1% to 0.3%, allow treatment approaches to be adapted to the specific needs of patients living with dry eye disease.
References
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Wolffsohn JS, et al. TFOS DEWS III: Diagnostic Methodology. Am J Ophthalmol. 2025;279:387-450.
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NICE CKS. Dry eye disease. January 2023. Available at: https://cks.nice.org.uk/topics/dry-eye-disease/. Accessed November 2025.
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Stapleton F, Alves M, Bunya VY, et al. TFOS DEWS II epidemiology report. Ocul Surf. 2017;15:334-65.
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NICE CKS. Dry eye disease. January 2023. Available at: https://cks.nice.org.uk/topics/dry-eye-disease/background-information/causes/. Accessed November 2025.
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Golden MI, Meyer JJ, Zeppieri M, Patel BC. Dry eye syndrome. February 2024. StatPearls [Internet]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470411/. Accessed November 2025.
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NICE CKS. Dry eye disease. January 2023. https://cks.nice.org.uk/topics/dry-eye-disease/diagnosis/diagnosis/. Accessed November 2025.
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Jones L, Craig JP, Markoulli M, et al. TFOS DEWS III: management and therapy. Am J Ophthalmol 2025;279:289-386.
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NICE CKS. Dry eye disease. January 2023. Available at: https://cks.nice.org.uk/topics/dry-eye-disease/management/management/. Accessed November 2025.
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Yang YJ, Lee WY, Kim YJ, Hong YP. . A meta-analysis of the efficacy of hyaluronic acid eye drops for the treatment of dry eye syndrome. Int J Environ Res Public Health. 2021;18(5):2383.
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Nakamura M, Hikida M, Nakano T, Ito S, Hamano T, Kinoshita S. Characterization of water retentive properties of hyaluronan. Cornea. 1993;12(5):433-6.
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Mochizuki H, Yamada M, Hato S, Nishida T. Fluorophotometric measurement of the precorneal residence time of topically applied hyaluronic acid. Br J Ophthalmol. 2008;92(1):108-11.