Coming to Terms with Dry Eye Disease

Dry eye is an issue in every area of eye care, especially the cataract, refractive, corneal, and glaucoma specialties. Attendees at the 2025 ESCRS Annual Congress had many opportunities to learn what’s new in the diagnosis and management of dry eye disease (DED), with 1 Masterclass, 3 entire sessions, 43 abstracts, and 85 presentations devoted to the topic.

Research presented in a poster session found that more than half of the general population in the US and Europe experience DED, yet only 20% of European patients and 17% of US patients were diagnosed, and they can wait years for professional help.

“Results from our studies reveal a substantial group of patients suffering without help,” Piotr Wozniak MD, PhD said. “The European questionnaire explored why people don’t seek treatment. Many see dry eye as a normal part of ageing and something to endure. As a medical doctor, I find this particularly concerning because a simple eye drop could offer significant relief—but many people aren’t even asking for help.”

Dr Wozniak presented findings from a survey of 2,003 adults in the US conducted in April 2024, and from an ongoing, international arm of the study conducted by Bausch + Lomb with more than 5,000 adults in the UK, France, Germany, Poland, and Saudi Arabia called the ‘Needs Unmet in Dry Eye: Symptoms, Treatment and Severity’ (NESTS) study. In June 2025, the NESTS international arm surveyed 2,580 adults in the general population and 2,572 dry eye patients.

“In the NESTS study, we found that 58% of the general population reported experiencing dry eye symptoms, yet only one in five has received a formal diagnosis from a healthcare provider,” he said. “The large size of this study makes these results robust.

“The study explored the patient journey in detail. What stood out was that up to one-third of patients had experienced symptoms for more than five years before seeking professional help. NESTS also found that around half of patients experience symptoms every single day. The delay in seeking treatment is concerning, especially since dry eye is a progressive disease and early intervention can prevent a vicious cycle of inflammation.”

Other results from NESTS showed that 60% of dry eye patients waited at least four months before seeking help, and 20% waited more than a year before talking to healthcare providers.

Many stopped driving at night (17.0%), no longer wore makeup (14.8%), or reduced their use of heat or air conditioning (15.2%) due to their uncontrolled dry eye symptoms. One in three (34.0%) reported that their symptoms had worsened over the past year, and only 9.0% noted an improvement.

“These findings highlight the widespread impact of dry eye disease on quality of life, showing many people suffering silently,” Dr Wozniak said.

“We need to educate patients and the public on the causes, consequences, and treatment options for dry eyes, as well as the importance of regular eye checks. In addition, we must support healthcare professionals in distinguishing between different types of dry eye and matching treatments appropriately. One person’s dry eye can be very different from another’s.”

Piotr Wozniak MD, PhD is a refractive surgeon and dry eye specialist at Optegra Eye Clinics and a lecturer and clinical instructor at Cardinal Stefan Wyszyński University, both of Warsaw, Poland.