Tear Film-Based Diagnostics and Emerging Tissue Engineering Approaches in Personalized Dry Eye Disease Management.

Abstract

Purpose: The dry eye disease(DED) is caused by many possible factors, manifesting classical symptoms such as irritation, pain, and visual disturbance, which can severely impact the quality of life.  This review aims to critically evaluate currently available point‑of‑care (POC) diagnostic kits for DED, focusing on osmolarity‑based and biomarker‑based assays, while exploring emerging technologies that promise better precision and personalized management.

Methods: A comprehensive literature survey (2010-2025) was undertaken using PubMed, Scopus, and Google Scholar to identify studies assessing DED pathophysiology, tear film biomarkers, and commercially available diagnostic systems. Particular emphasis was placed on kits measuring tear osmolarity (TearLab, I-PEN, ScoutPro) and inflammatory or protective biomarkers (MMP‑9, lactoferrin, IL‑6).

Results: Osmolarity‑based kits provide rapid, reproducible insights into tear hyperosmolarity, a recognized hallmark of DED, but also has limitations due to environmental variability, reflex tearing, and cost. Biomarker‑based kits, particularly MMP‑9 (InflammaDry) and lactoferrin assays, enhance diagnostic specificity by targeting ocular surface inflammation and lacrimal gland dysfunction, respectively. Emerging multiplex immunoassays, nanobiosensors, and paper‑based microfluidic platforms offer quick, low‑volume demand, and multi‑analyte detection with precise disease stratification potential.

Conclusion: Current diagnostic kits have improved early detection and management of DED but are still limited by single parameter constraints, moderate reproducibility, and high costs. The combination of multiplex biomarker panels, biosensor technologies, and patient-specific organ-on-chip models is a promising deal toward precision diagnostics.