Dry Eye – Fidia Farmaceutici S.p.a.



Dry eye disease (DED) is a complex ocular surface disease in which the tear film is unbalanced. A healthy tear film consists of three layers: lipid, aqueous, and mucin layer. In DED the tear film no longer provides sufficient nourishment or protection to the ocular surface. This imbalance can lead to a permanent damage to the corneal and conjunctival cells and the corneal nerve fibres that trigger secretion.

(Baudouin C et al. Role of Hyperosmolarity in the Pathogenesis and Management of Dry Eye Disease: Proceedings of the OCEAN Group Meeting. Ocul Surf 2013; 11(4):246-258)


Fidia’s many decades of experience on hyaluronic acid is the best guarantee of top quality and maximum safety in the treatment of DED. Hyaluronic acid is an essential component of the artificial tears destined to protect and lubricates the ocular surface, thereby restoring tear film physiology, reducing surface stress and providing long-lasting relief from mechanical, environmental, and visual stress.




Dry eye disease has many causes, which often overlap and interact: it may be due to environmental factors, lifestyles, conditions or medications. This is why DED is defined as a multifactorial disease of the tears and ocular surface.

(Clayton JA. Dry Eye. N Engl J Med. 2018;379(11))


DED can develop after cataract or refractive surgeries, due to the severing of the corneal nerves, poor tear film production and stability due to surgically induced ocular inflammation.

(Ishrat S, Nema N, Chandravanshi SCL. Incidence and pattern of dry eye after cataract surgery. Saudi J Ophthalmol. 2019;33(1):34-40)


Dry eye disease can be induced by topical medications because of their allergic, toxic and immuno-inflammatory effects on the ocular surface. Preservatives may further aggravate DED.

(José Alvaro P.Gomes et al., The Ocular Surface, TFOS DEWS II iatrogenic report, Volume 15, Issue 3, July 2017, Pages 511-538)


Evaporative DED is due to a deficient tear film lipid layer, which increases tear evaporation. It is caused by meibomian gland dysfunction, which occurs in over 85% of dry eye disease.

(Findlay Q, Reid K. Dry eye disease: when to treat and when to refer. Aust Prescr. 2018;41(5):160-163)


Environmental factors are often implicated in dry eye, including exposure to ultraviolet (UV) radiation and blue light from videoterminals and smartphones. These factors increase oxidative stress and ocular surface inflammation.

(Heidari M, Noorizadeh F, Wu K, Inomata T, Mashaghi A. Dry Eye Disease: Emerging Approaches to Disease Analysis and Therapy. J Clin Med. 2019;8(9):1439)


Ageing is a significant risk factor for dry eye. DED prevalence increases in women and men every five years after the age of 50, with greater prevalence in women compared to men.

(de Paiva CS. Effects of Aging in Dry Eye. Int Ophthalmol Clin. 2017;57(2):47-64)


Diabetes mellitus has been identified as one of the leading causes of dry eye disease. Increasing prevalence of diabetes-associated DED has been reported in recent years.

(Zhang X, Zhao L, Deng S, Sun X, Wang N. Dry Eye Syndrome in Patients with Diabetes Mellitus: Prevalence, Etiology, and Clinical Characteristics. J Ophthalmol. 2016;2016:8201053)


Contact lenses wearers have a higher risk of DED, induced by the instability of the pre-lens tear film, and increased friction between the contact lens and the ocular surface.

(Takashi Kojima, Contact Lens-Associated Dry Eye Disease: Recent Advances Worldwide and in Japan, Investigative Ophthalmology & Visual Science November 2018, Vol.59, DES102-DES108. Special Issue | November 2018)


Appropriate lid hygiene is important in the management of a variety of lid conditions that result in dry eye (particularly blepharitis) and, if used appropriately, can reduce lipid by-products and lipolytic bacteria associated with these conditions.

(L. Jones et al. TFOS DEWS II Management and Therapy Report. The Ocular Surface (2017) 580-634)