Understanding Dry Eye Disease: A Common Yet Overlooked Condition
Dry eyes can cause significant discomfort, and the symptoms become more prevalent as individuals age. Until recently, the exact proportion of the population affected by this condition was uncertain, with estimates varying between 5% and 50%.
Prevalence of Dry Eye Symptoms
Research presented at the 43rd Congress of the European Society of Cataract and Refractive Surgeons (ESCRS) on September 15 indicates that more than half of the general population in the USA and Europe experiences symptoms of dry eyes. However, only 20% of European patients and 17% of US patients receive a formal diagnosis, with many individuals waiting years for professional assistance.
Insights from Experts
Dr. Piotr Wozniak, a refractive surgeon and dry eye specialist at Optegra Eye Clinics in Warsaw, emphasized the alarming findings: “Results from our studies reveal a substantial number of patients suffering without help. The European questionnaire explored reasons why individuals do not seek treatment, with many perceiving dry eye as a normal part of aging. As a medical doctor, I find this particularly concerning, as a simple eye drop could provide significant relief—but many aren’t even asking for help.”
Survey Findings from the NESTS Study
Dr. Wozniak presented findings from two significant surveys: one involving 2,003 adults in the US conducted in April 2024, and another ongoing international study led by Bausch and Lomb, which surveyed over 5,000 adults across the UK, France, Germany, Poland, and Saudi Arabia. The international arm of the ‘Needs Unmet in Dry Eye: Symptoms, Treatment and Severity’ (NESTS) study surveyed 2,580 adults in June 2025, including 2,572 dry eye sufferers.
“In the NESTS study, we found that 58% of the general population reported experiencing dry eye symptoms, yet only one in five received a formal diagnosis from a healthcare provider. The extensive size of this study enhances the reliability of these findings,” Dr. Wozniak remarked.
The Delay in Seeking Treatment
The study offered detailed insights into patient behavior, revealing that up to one-third of dry eye sufferers experience symptoms for more than five years prior to seeking professional treatment. Alarmingly, around half of these individuals report daily symptoms. Additionally, NESTS discovered that 60% of patients waited at least four months before consulting a healthcare provider, with 20% postponing their visit for over a year. The impact of uncontrolled dry eye symptoms is profound, with 17% of sufferers ceasing to drive at night, 14.8% refraining from wearing makeup, and 15.2% reducing the use of heaters or air conditioning. One in three reported worsening symptoms within the past year, while only 9% acknowledged any improvement.
Current Treatment Options
Lubricating eye drops emerged as the most common treatment option, either chosen by the patients themselves or recommended by healthcare providers. However, only 25% of participants felt that their current treatment was tailored to their specific needs.
International Differences in Patient Care
Dr. Wozniak noted variances in patient-provider interactions, with fewer than half of dry eye sufferers in France attending planned follow-up visits, in contrast to 84% in Saudi Arabia receiving proactive follow-up care from their providers.
Impact on Quality of Life
In the US study, dry eye symptoms affected 50% of respondents, with 80% experiencing related issues such as fatigue, itchy, or watery eyes. Notably, only 17% had a diagnosis from an eye care provider. A significant number (35-75%) reported being very or extremely bothered by their symptoms, with activities like reading, using electronic devices, and driving frequently disrupted. Alarmingly, 70% lacked awareness of available treatment options, 40% were unaware that untreated dry eyes could lead to other ocular issues or vision loss, and only 25% visited an eye care provider every two years or more regularly.
The Need for Awareness and Education
Dr. Wozniak concluded, “These findings underscore the widespread impact of dry eye disease on quality of life, highlighting a significant population suffering in silence. It is crucial to educate both patients and the public about the causes, consequences, and treatment options for dry eyes, as well as the importance of regular eye examinations. Furthermore, healthcare professionals must be trained to differentiate between various types of dry eye and apply appropriate treatments, recognizing that each individual’s experience with dry eye can differ.”
Diagnosis and Consequences of Untreated Dry Eye
Diagnosing dry eye typically involves a combination of patient-reported symptoms, medical history, and clinical tests. Unfortunately, some patients may receive a diagnosis based solely on symptoms and a basic eye examination. Diagnostic tools may include evaluating the time it takes for dryness to appear on the cornea after a blink, using dye to stain the eye surface, measuring tear composition, or assessing the Meibomian glands responsible for tear oil production.
If left untreated, dry eyes can result in considerable discomfort and complications such as inflammation and blepharitis, a condition characterized by inflamed eyelids. Symptoms may include a gritty sensation, eye pain, itching or burning sensations, temporary blurred vision, and episodes of excessive tearing. Notably, dry eyes are more prevalent in individuals over 50, as tear production diminishes over time, leading to dryness and irritation. This condition can also adversely affect the results of various ophthalmological surgeries, highlighting the importance of timely diagnosis and management.
Environmental factors such as dry, windy, or cold weather, air conditioning, central heating, smoking, and certain medical conditions (including autoimmune and hormonal disorders) can exacerbate dry eye symptoms.
Expert Commentary
Dr. Filomena Ribeiro, President of ESCRS and Head of the Ophthalmology Department at Hospital da Luz in Lisbon, Portugal, who was not involved in the research, stated, “These findings reveal the true extent of dry eye disease within the general population. It is concerning that a minimal number of sufferers seek help, especially given the impact on both surgical outcomes and overall quality of life. Eye and healthcare professionals need to engage in discussions about this condition with their patients and advocate for regular eye check-ups.”
Key Health Takeaway
Dry eye disease is a widespread condition that significantly affects quality of life, yet it often goes untreated. Increased awareness, education on available treatments, and regular eye care check-ups are essential for managing this prevalent issue effectively.
Notes
- ESCRS25-PP-3336, ‘Dry eye symptoms, severity, treatment and unmet needs: an analysis of the United States of America and a multinational snapshot’, by Piotr Wozniak et al. Poster session: Ocular surface disease. 09:15-10:45 hrs CEST, Monday, September 15, https://pag.virtual-meeting.org/escrs/escrs2025/en-GB/pag/presentation/572147
- Data from the NESTS international arm became available after the abstract was submitted. The information in this release represents the most current data presented at the Congress.
