Current and emerging pharmacological treatment options for patients with dry eye disease

INTRODUCTION: To provide an up-to-date overview of current pharmacological treatments and promising emerging therapies for dry eye disease (DED), a multifactorial and increasingly prevalent ocular surface disorder. AREAS COVERED: A targeted literature search was conducted using PubMed, Scopus, ClinicalTrials.gov, and additional online sources to identify recent advances in the pharmacological management of DED. The review focuses on therapies approved across major regulatory bodies, as well as investigational agents in late-stage clinical development. Special attention is given to novel drug delivery platforms and innovative therapeutic mechanisms. EXPERT OPINION: Rapid innovation in both therapeutic targets and drug delivery technologies is transforming the treatment landscape for DED. Advanced formulations, such as nanomicelles, mucus-penetrating particles, and preservative-free emulsions, are improving ocular bioavailability, reducing adverse effects, and enhancing patient adherence. The future of DED pharmacotherapy lies in personalized, multimodal strategies that address the full spectrum of disease mechanisms, including inflammation, tear film instability, neurosensory dysfunction, and epithelial damage. The recent FDA approval of AR-15512, a TRPM8 agonist, exemplifies the trend toward mechanism-specific therapies designed to deliver both symptomatic relief and disease modification. As the therapeutic armamentarium expands globally, continued clinical trials and real-world studies will be essential to ensure durable efficacy and optimize patient outcomes.