Bridging Therapeutics and Nanotechnology in Dry Eye Disease: A Review of Risk Factors, Drug Delivery Barriers, and Recent and Future Endeavors for Disease Management

Dry eye disease (DED) is a multifactorial ocular disorder with high prevalence among global population, characterized by tear film instability, hyperosmolarity, and ocular surface inflammation, leading to impaired vision and reduced quality of life. This review critically examines intrinsic and extrinsic risk factors contributing to DED pathogenesis, highlights its major subtypes, and evaluates current therapeutic interventions ranging from tear substitutes and pharmacological agents to advanced biological approaches such as autologous serum and platelet-rich plasma. Despite the widespread use of conventional therapies, ocular anatomical and physiological barriers limit drug bioavailability and therapeutic efficacy. Consequently, nanotechnology-based drug delivery systems-including liposomes, dendrimers, nanoemulsions, and microneedles-have emerged as promising strategies to enhance ocular drug retention, permeability, and controlled release. Moreover, artificial intelligence (AI) applications in diagnosis and disease stratification present novel opportunities for precision therapeutics in DED management. This review integrates recent advances in nanomedicine and AI, outlining future perspectives for overcoming existing challenges and translating innovative therapies into clinical practice.