Defining dry eye from a clinical perspective

Kazuo Tsubota, Stephen C. Pflugfelder, Zuguo Liu, Christophe Baudouin, Hyo Myung Kim, Elisabeth M. Messmer, Friedrich Kruse, Lingyi Liang, Jimena Tatiana Carreno-Galeano, Maurizio Rolando, Norihiko Yokoi, Shigeru Kinoshita, Reza Dana

Research output: Contribution to journalReview articlepeer-review

129 Citations (Scopus)


Over the past decades, the number of patients with dry eye disease (DED) has increased dramatically. The incidence of DED is higher in Asia than in Europe and North America, suggesting the involvement of cultural or racial factors in DED etiology. Although many definitions of DED have been used, discrepancies exist between the various definitions of dry eye disease (DED) used across the globe. This article presents a clinical consensus on the definition of DED, as formulated in four meetings with global DED experts. The proposed new definition is as follows: “Dry eye is a multifactorial disease characterized by a persistently unstable and/or deficient tear film (TF) causing discomfort and/or visual impairment, accompanied by variable degrees of ocular surface epitheliopathy, inflammation and neurosensory abnormalities.” The key criteria for the diagnosis of DED are unstable TF, inflammation, ocular discomfort and visual impairment. This definition also recommends the assessment of ocular surface epitheliopathy and neurosensory abnormalities in each patient with suspected DED. It is easily applicable in clinical practice and should help practitioners diagnose DED consistently. This consensus definition of DED should also help to guide research and clinical trials that, to date, have been hampered by the lack of an established surrogate endpoint.

Original languageEnglish
Article number9271
Pages (from-to)1-24
Number of pages24
JournalInternational journal of molecular sciences
Issue number23
Publication statusPublished - 2020 Dec 1


  • Corneal epitheliopathy
  • Definition
  • Dry eye
  • Dry eye signs
  • Dry eye symptoms
  • Inflammation
  • Neuropathic pain
  • Tear film breakup

ASJC Scopus subject areas

  • Catalysis
  • Molecular Biology
  • Spectroscopy
  • Computer Science Applications
  • Physical and Theoretical Chemistry
  • Organic Chemistry
  • Inorganic Chemistry


Dive into the research topics of 'Defining dry eye from a clinical perspective'. Together they form a unique fingerprint.

Cite this