The Tear Film & Ocular Surface Society’s (TFOS) Dry Eye Workshop (DEWS) III report marks the latest comprehensive review of strategies to manage dry eye disease (DED). Released in June 2025, DEWS III builds on earlier TFOS reports by presenting an evidence-based framework for both clinicians and researchers. Its goal: to provide clear, practical guidance on how to address the multifactorial nature of dry eye using the best available science.
A Multifaceted Condition
Dry eye disease remains one of the most common ocular disorders worldwide, affecting both quality of life and daily functioning. Because DED is complex and does not have a single cause, TFOS has long emphasized that its management must be multifaceted. DEWS III continues this approach, offering a detailed prescribing algorithm designed to help clinicians tailor strategies to each patient’s underlying etiology and disease subtype.
Core Management Approaches
First-line management still centers on replenishing, conserving, and stimulating the tear film. Ocular supplements, particularly artificial tears, remain the cornerstone of treatment. These interventions are often combined with lifestyle modifications such as optimizing blink habits, improving diet, and modifying the environment to reduce symptoms.
Addressing Meibomian Gland Dysfunction
Because meibomian gland dysfunction is a primary contributor to DED, DEWS III emphasizes lid-based treatments. These range from home remedies, such as warm compresses, to a growing list of in-office procedures. Options include device-based eyelid heating, intense pulsed light (IPL), and low-level light therapy. Additional measures may involve lid hygiene treatments, blepharoexfoliation, anti-Demodex therapies, and topical antibiotics.
Anti-Inflammatory and Advanced Therapies
For DED with inflammatory drivers, DEWS III highlights a broad range of pharmacologic and biologic options. These include corticosteroids, T-cell immunomodulatory drugs, and other agents, as well as biologic tear substitutes such as autologous serum and platelet-rich plasma. In severe or refractory cases, advanced approaches such as amniotic membrane grafts or surgical interventions, may be needed.
Emerging Therapies
Looking ahead, DEWS III points to several emerging therapies. Neuromodulation, including nasal neurostimulation, shows promise, while novel pharmacologic agents are under investigation, with the aim of targeting dry eye through new mechanisms. These developments highlight ongoing innovation in the field.
Why DEWS III Matters
The release of DEWS III is significant not because it introduces a single “new” therapy, but because it brings together the breadth of available evidence into a coherent, practical framework. It validates the progress made since DEWS II and emphasizes that DED requires ongoing reevaluation as new therapies and technologies emerge. For clinicians, it serves as a roadmap. For patients, it represents hope that dry eye care will continue to advance in both scope and precision.
As DEWS III makes clear, dry eye care is entering a new era — one that integrates established therapies with innovative new approaches. At Surface Ophthalmics, we are actively developing investigational treatments that aim to expand options for patients. Learn more about our development pipeline here: surfaceophthalmics.com/pipeline.
Read the abstract and the full report:
- TFOS DEWS III Management and Therapy Report – PubMed
- TFOS DEWS III Management and Therapy Report – American Journal of Ophthalmology