Biosensor-embedded wearables for dry eye monitoring and management

Dry eye disease (DED) affects over 300 million people worldwide and continues to pose diagnostic challenges due to fluctuating symptoms and reliance on static, clinic-based tests. Conventional methods such as Schirmer's test and tear osmolarity provide only episodic insights, failing to capture the dynamic behavior of the tear film. Recently, biosensor-embedded wearable devices, including smart contact lenses, eyelid-mounted patches, and sensor-equipped spectacles, have emerged, enabling real-time and continuous tracking of tear metrics and blink patterns. These technologies promise precision diagnostics and patient-specific therapeutic strategies.

This review summarizes recent advances in ocular biosensor wearables for DED. Key innovations include smart lenses with osmolarity and biomarker sensors, microfluidic channels for tear collection, and eyelid-mounted iontronic sensors for blink monitoring. Regulatory pathways such as FDA 510(k), ISO 10,993 safety standards, and HL7 FHIR for data integration are discussed. Early clinical studies support feasibility, though power supply, device miniaturization, and patient adherence remain obstacles. Ethical, economic, and privacy considerations are also highlighted.

Biosensor-based wearables are redefining DED care, offering precision diagnostics, early intervention, and long-term monitoring. Their success depends on clinical validation, affordability, patient comfort, and seamless integration with telehealth. Interdisciplinary collaboration will be crucial to transition these innovations into routine clinical practice.