[Treatment of Dry Eye Disease - Current recommendations according to DEWS III report]

Dry eye disease (DED) is one of the most common chronic disorders of the ocular surface. It is clinically relevant because it can cause pronounced complaints such as burning, pain, blurred vision, foreign body sensation, photophobia or severe visual disturbance. According to the current pathophysiological understanding, dry eye is a multifactorial, symptomatic disease characterised by a loss of homeostasis of the tear film and/or the ocular surface. Etiologically, tear film instability, hyperosmolarity, inflammatory mechanisms and neurosensory abnormalities play a decisive role.Treating dry eye is one of the most demanding tasks in ophthalmological practice. Patients often present with a high burden of suffering. The multifactorial origin of dry eye calls for a time-intensive, detailed history and differentiated diagnostic work-up. Treatment frequently poses a considerable challenge for the treating physicians and for the affected patients. Current diagnostic and therapeutic recommendations are based on the DEWS III (Dry Eye Workshop III) report of 2025. Therapy no longer follows a stepwise scheme exclusively; instead, an individualised, etiology-oriented, targeted combination therapy is recommended. Particular importance is attached to the recognition of systemic causes, to taking neuropathic pain components into account, and to interdisciplinary collaboration.