Abstract:Dry eye is a common ocular condition characterized by multifactorial etiology, involving abnormalities in the quality, quantity, and dynamics of tears, leading to tear film instability and imbalance of the ocular surface microenvironment. Its pathogenesis is complex and not only associated with local ocular factors but also linked to various systemic diseases, making it an interdisciplinary disorder that increases the challenge of clinical diagnosis and treatment. This review systematically elaborates on the associations between dry eye disease and systemic factors such as autoimmune, metabolic, endocrine, and psychiatric disorders, and further investigates the core pathogenic mechanisms, namely inflammatory responses, oxidative stress, neuro-immune interactions, and tear film compositional changes. Thus, this review provides a theoretical basis for understanding the multisystem etiology of dry eye and offers novel insights for comprehensive clinical management and fundamental research.
