Cesk Slov Oftalmol. 2021 Winter;77(3):107–119. doi: 10.31348/2020/29.


This article provides a comprehensive view of the issue of dry eye. It emphasizes provisions of the Tear Film and Ocular Surface Society, discusses the new classification and definition of dry eye based on its pathophysiology, and emphasizes the correct diagnostic and therapeutic approaches, which appears in the form of algorithms. Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles. Dry eye disease is a dynamic and complex disease of the ocular surface and ocular adnexa with known risk factors. It is a disease with a cyclical character, in which the most important step is to find the etiological trigger, to restore homeostasis and break the vicious circle. The key elements in the diagnosis are increased osmolarity of the tear film and inflammation of the ocular surface, which are accompanied by ocular symptoms (discomfort, visual disturbance). Inflammation is not always associated with hyperemia and can be confirmed by several techniques and methods. However, in current clinical practice, there is still no "gold standard" and sufficient tests to diagnose inflammation of the ocular surface. The treatment of dry eye disease must be individualized, dynamic and optimized for each stage of the disease.

Keywords: ADDE; DEWS; DEWS II; EDE; MGD; TFOS; dry eye disease; vicious circle.

Publication types

  • Review

MeSH terms

  • Dry Eye Syndromes* / diagnosis
  • Dry Eye Syndromes* / etiology
  • Dry Eye Syndromes* / therapy
  • Eye
  • Humans
  • Osmolar Concentration
  • Tears
  • Vision, Ocular