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Dry eye disease (DED) is a very common ocular condition with a considerable socioeconomic impact affecting patient’s visual function and quality of life. Currently, thanks to the better knowledge on DED pathophysiology, therapeutical approaches are focused on the primary core mechanisms of DED. Furthermore, new drugs and compounds are being explored in the light of recent findings concerning unique disease-related pathways. The purpose of this review is to stress DED pathogenesis, addressing its vicious cycle, and highlighting the cutting-edge drug therapy approaches under development. A literature search on the PubMed and Scopus databases was carried out. The database search strategy was formulated around the term ‘dry eye disease’ and other terms regarding its pathophysiology and therapeutic strategy. Additional search was conducted on ClinicalTrials.gov for unpublished results and ongoing clinical trials. The primary approaches used for DED include lifestyle, environmental changes, tears supplementation, and control of the eyelids and ocular surface inflammation. In selected cases, medical therapy could benefit by technological device-based management. Due to the complexity of DED and the continuous growth of disease prevalence and patients’ unmet needs, new therapeutic approaches focused on its pathogenesis are currently under investigation, while others are pending approval.

The vicious cycle of dry eye disease: a look into promising novel drug therapies