Optimizing Dry Eye Management: An Expert Consensus on the Use of Sodium Hyaluronate at Different Concentrations

Background: Dry eye disease (DED) is a common, multifactorial disorder that affects ocular comfort and visual quality.Despite widespread use of sodium hyaluronate (SH) as a lubricant, the selection of appropriate SH concentration and formulation for different stages of DED has not been standardized in India.Methods: This expert consensus was developed through a modified Delphi process with 23 renowned ophthalmologists reviewing available evidence and forming consensus statements on diagnosis, SH concentration, preservative-free options, dosing, and unmet needs.Results: The panel recommended a stepwise approach: 0.1% SH for mild disease, 0.18% SH for moderate disease balancing efficacy and comfort, and preservative-free 0.3% SH for moderate-to-severe or postsurgical DED.The experts also emphasized the importance of preservative-free formulations, individualized dosing schedules, and patient education to ensure sustained symptom relief and adherence.Conclusion: The purpose of this consensus is to unify practice and guide evidence-based management of DED in India.