Eye health is an important component of public health. With the continuous aging of the population and the increasing popularity of digital lifestyles, the incidence of dry eye in China has been rising year by year, and the affected population is showing a younger trend. Epidemiological data show that the number of dry eye patients in China has exceeded 360 million, but the treatment rate is less than 8%.

The 12th National Dry Eye Academic Conference and the 2026 National Cornea and Ocular Surface Disease Academic Annual Meeting will be held in Shanghai on October 23, and the 2027 China Dry Eye Science Popularization Campaign will also be launched at this conference. On the occasion of the conference, Professor Liu Zuguo, a pioneer in China's dry eye discipline, Treasurer of the Global Board of the International Tear Film & Ocular Surface Society (TFOS), and chairman of this conference, said in an interview that the upcoming 2027 is a critical node for the Healthy China initiative, and dry eye, as one of the most common diseases with the highest outpatient volume in ophthalmology, must adhere to prevention first and early intervention, promote coordinated development of disease awareness, clinical diagnosis and treatment, and long-term management, so that scientific eye health concepts and standardized diagnostic and treatment services can benefit more patients.

Dry eye is not just "lack of water"

In public perception, dry eye is often simply understood as eye dryness, and artificial tears have therefore become the first choice for many people. However, with in-depth research, the medical community's understanding of dry eye has expanded from focusing solely on tear deficiency to tear film homeostasis imbalance, ocular surface damage, inflammation, and neurosensory abnormalities.

The "Chinese Dry Eye Clinical Diagnosis and Treatment Expert Consensus (2024)" and the international TFOS DEWS III have updated the definition of dry eye almost simultaneously, clarifying that dry eye is a "chronic inflammatory ocular surface disease" requiring long-term management, and classifying it by etiology into five types: aqueous deficiency, lipid abnormality, mucin deficiency, tear dynamics abnormality, and mixed type. This means that dry eye is not a single problem. The "hydration" eye drops purchased by the public can often only address some of these types and have limited effect on most other types of dry eye. Therefore, the first step in dry eye prevention and treatment is not blind medication, but risk identification, etiology clarification, and disease severity assessment.

Professor Liu Zuguo reminds the public that there are three common misconceptions about dry eye: first, thinking that dry eye is just dryness; second, buying internet-famous eye drops on their own; third, ignoring the root cause of chronic inflammation. These three points are precisely the main reasons for delayed standardized diagnosis and treatment. He also emphasized that if symptoms such as eye dryness, foreign body sensation, and burning sensation persist, recur, or gradually worsen after reducing screen time and getting sufficient rest, they should promptly go to a formal medical institution for examination to avoid self-medication and delay the diagnosis and treatment of other eye diseases. In addition, people with systemic diseases such as Sjögren's syndrome, rheumatoid arthritis, and systemic lupus erythematosus should also pay attention to ocular surface evaluation.

From "hydration and soothing" to scientific anti-inflammation: treatment concepts and clinical practice continue to evolve

"Ocular surface inflammation" is a concept that Professor Liu Zuguo focused on explaining in the interview. The inflammation of dry eye is not caused by bacterial or viral infections, but is an immune inflammation produced by some patients after the tear environment that maintains ocular surface stability is destroyed and tear osmolarity increases. A clinical observation showed that some patients had unsatisfactory symptom control after long-term use of artificial tears, suggesting that simple hydration has limitations.

Professor Liu Zuguo used a vivid metaphor to explain the relationship between inflammation and treatment: if inflammation is compared to a "fire," anti-inflammatory treatment is like helping to control the fire. The latest TFOS DEWS III report released in 2025, integrating expert resources from more than 30 countries and nearly a thousand latest clinical studies, clearly positions inflammation as a cause of dry eye rather than just a result, marking a shift in dry eye treatment from "symptomatic relief" to "etiology-driven precise management."

It is precisely in this conceptual shift that 0.05% cyclosporine eye drops have attracted widespread attention in dry eye anti-inflammatory treatment. DEWS III includes 12 original studies from Chinese teams, among which the clinical data of China's innovative drug Zirun® 0.05% cyclosporine eye drops (II) is listed as one of the key evidence, further supporting its position as a first-line drug for dry eye anti-inflammatory treatment. This is also the first and only time that Chinese dry eye innovative drug research has received key recommendations in an international authoritative dry eye consensus.

Supporting this clinical positioning is solid local research data. A Phase IV clinical study of 0.05% cyclosporine eye drops (II) covering 44 research centers nationwide and involving 1,999 dry eye patients showed that subjects' dry eye symptoms were effectively improved after 2 weeks of medication. At week 24, 54% of patients experienced a reversal of dry eye severity. The incidence of adverse reactions during treatment was only 7.4%, and most were mild and tolerable common ocular adverse reactions.

Professor Liu Zuguo believes that China has a huge patient base and rich clinical resources, which is driving the international diagnosis and treatment logic of dry eye to evolve from "Western data dominance" to "co-construction of Chinese solutions." Under the premise of standardized training and follow-up, primary care doctors can provide long-term standardized treatment for suitable patients and implement anti-inflammatory treatment.

Aligning with "15th Five-Year Plan" eye health construction: making prevention and treatment services cover the entire life cycle

During the "15th Five-Year Plan" period, eye health-related plans propose to promote the transformation of the medical and health development mode from disease-centered to health-centered, and emphasize digital and intelligent transformation, primary health management capacity building, and balanced and accessible medical services.

In Professor Liu Zuguo's view, moving dry eye prevention and treatment earlier requires both the public to master basic eye health knowledge and primary care institutions to improve identification, preliminary assessment, and referral capabilities. However, the reality gap in primary care diagnostic and treatment capabilities cannot be ignored. Professor Liu Zuguo pointed out that many primary hospitals in remote areas are not equipped with ophthalmologists, and general practitioners have relatively limited knowledge of eye diseases, making it difficult to accurately diagnose and manage dry eye.

Hierarchical diagnosis and treatment is a core lever and key institutional arrangement for building a high-quality and efficient medical and health service system. Facing a huge number of potential patients, relying solely on specialist outpatient clinics in large hospitals cannot meet all needs. The standardized dry eye chronic disease management system explored by Professor Liu Zuguo's team in Xiamen has gradually formed standardized diagnostic and treatment pathways and follow-up specifications that can be promoted to primary care. The "Smart Eye Guardian" WeChat mini-program developed by his research team is used for preliminary risk assessment and health management, and an upcoming fully automated ophthalmic disease screening robot can autonomously complete screening for common eye diseases and provide patients with preliminary treatment suggestions. For patients requiring further treatment, it clearly informs them of the hospital they should go to, thereby effectively triaging patients and treating them according to their conditions.

Looking to the future, Professor Liu Zuguo believes that it is necessary to further connect the collaborative chain among individuals, families, communities, and specialized hospitals: the public can identify risks, primary care doctors can conduct preliminary assessments, complex cases can be referred in a timely manner, and patients can receive standardized treatment and continuous follow-up after a clear diagnosis.

Using academic conferences to build consensus and bring high-quality eye health services to more people

"The National Dry Eye Conference has been successfully held for 11 sessions, building an important platform for ophthalmologists from different regions and levels to exchange research progress, share clinical experience, and discuss standardized diagnosis and treatment. The upcoming 12th National Dry Eye Academic Conference will further promote the standardization of dry eye diagnosis and treatment and the balanced development of service capabilities among regions by building academic consensus, strengthening professional training, and promoting the connection between research results and clinical practice," Professor Liu Zuguo pointed out.

In the process of shifting from "disease-centered" to "people's health-centered," doctors and patients are comrades on the same front. Doctors provide professional plans, patients actively manage their health, and the whole society supports them. All three are indispensable.

In this regard, Professor Liu Zuguo hopes the public will remember three sentences: dry eyes do not equal dry eye disease; persistent discomfort requires timely medical attention; dry eye is not simply a lack of water and cannot rely only on "hydration" eye drops; dry eye is a chronic inflammatory ocular surface disease requiring long-term management, emphasizing early diagnosis, standardized treatment, and long-term follow-up.

He further pointed out that dry eye is one of the few diseases where "personal behavior is directly related to the national eye health burden"—every hour of screen time reduced, every improvement in sleep, and every standardization of self-medication behavior is a "burden reduction" for lifelong eye health.

Professor Liu Zuguo finally emphasized that paying attention to eye health is related not only to personal quality of life but also to lifelong health management. Promoting early dry eye prevention and treatment must ultimately be implemented in earlier risk identification, more accurate clinical assessment, more standardized treatment, and more continuous health management, truly bringing high-quality eye health services to more people.