Dry eye disease: when to treat and when to refer

Dry eye disease affects one in five adults, and can significantly impair quality of life. Most patients have mild disease. This condition is multifactorial, with an inflammatory component which can markedly worsen the impact on the ocular surface. Meibomian gland dysfunction is extremely common in dry eye disease, and contributes to the inflammatory process. Management of mild disease includes identifying and removing precipitants, and symptomatic treatment with artificial tear supplements. More advanced disease requires management of underlying ophthalmic and systemic conditions, as well as more aggressive therapies to protect the ocular surface.