Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Dec 20, 2025; 15(4): 101033
Published online Dec 20, 2025. doi: 10.5662/wjm.v15.i4.101033
Diagnostic methods for managing dry eyes
Mutali Musa, Ayuba Suleman, Clinton Okechukwu, Babatunde Ismail Bale, Caterina Gagliano, Fabiana D’Esposito, Marco Zeppieri
Mutali Musa, Clinton Okechukwu, Babatunde Ismail Bale, Department of Optometry, University of Benin, Benin 300283, Nigeria
Ayuba Suleman, Department of Ophthalmology, Africa Eye Laser Centre Ltd, Benin 300105, Nigeria
Caterina Gagliano, Department of Medicine and Surgery, University of Enna "Kore", Catania 94100, Italy
Fabiana D’Esposito, Imperial College Ophthalmic Research Group Unit, Imperial College, London NW1 5QH, United Kingdom
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Marco Zeppieri, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste 34127, Italy
Author contributions: Musa M and Zeppieri M wrote the outline; Bale BI, Suleman A, Okechukwu C, and Zeppieri M performed the research and wrote the manuscript; Musa M, Suleman A, Okechukwu C, Bale BI, Gagliano C, D’Esposito F and Zeppieri M assisted in writing the draft and final paper, assisted in editing, making critical revisions of the manuscript and viewing all versions of the manuscript; Zeppieri M was responsible for the conception and design of the study and completed the English and scientific editing. All authors provided final approval of the article.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, Udine 33100, Italy. mark.zeppieri@asufc.sanita.fvg.it
Received: September 3, 2024
Revised: February 17, 2025
Accepted: February 27, 2025
Published online: December 20, 2025
Processing time: 335 Days and 23.2 Hours
Abstract
BACKGROUND

Dry eye disease (DED) represents a multifactorial condition characterized by ocular discomfort and visual disturbances. The management of DED relies heavily on accurate diagnosis to tailor effective treatments. Diagnostic approaches encompass both subjective and objective assessments.

AIM

To review the diagnostic methods used in the process of dry eye disease management.

METHODS

A comprehensive review of diagnostic approaches for dry eye was performed using scientific databases. Studies published within the last four years were considered. Studies were excluded if a full text was absent or the article was not written in English. Articles were assessed for relevancy, and a total of 107 studies were selected. The selection method used a systematic methodology, which guaranteed an exhaustive assessment of the diagnostic techniques reported in current literature. The study adheres to principles for systematic reviews ensuring dependability and accuracy. The studies were assessed for emphasize on both novel traditional and diagnostic methods for dry eye disease management.

RESULTS

Key objective tests include tear break-up time, which evaluates tear film stability; fluorescein and lissamine green staining, which assess ocular surface damage and inflammation; tear osmolarity measurement, indicative of tear film quality; and tear volume assessment via Schirmer's test, which evaluates tear production. Advanced imaging techniques such as optical coherence tomography and meibography offer detailed anatomical insights into the ocular surface and meibomian glands, aiding in the diagnosis of underlying structural abnormalities. Moreover, emerging technologies such as matrix metalloproteinase-9 testing and inflammatory biomarkers provide additional diagnostic precision, particularly in identifying inflammatory components of DED.

CONCLUSION

Integrating a combination of subjective and objective diagnostic tools allows clinicians to comprehensively assess the condition, tailor treatment plans, and monitor therapeutic efficacy. Continued advancements in diagnostic technologies promise to enhance our understanding and management of this prevalent ocular condition.

Keywords: Dry eye syndrome; Diagnostic methods; Tear film stability; Ocular surface; Meibomian glands

Core Tip: Keratoconjunctivitis sicca, or dry eye disease (DED), is a common ocular illness with different incidence rates worldwide. The complicated etiology of DED involves tear film instability and can cause pain, decreased vision, and ocular surface damage. Evaporative and aqueous-deficient dry eye have different causes. Differentiating between these types is often required for appropriate diagnosis and effective therapy. A detailed diagnosis is needed as Sjögren's syndrome, an autoimmune condition, is connected to a type of DED. Recent advances aim to standardize diagnosis and improve therapy by addressing the causes of DED.