Articles by Kruize et al and Tsubota et alin this issue of the BJO (pp 435 and 439), emphasise two important clinical aspects of dry eye or keratoconjunctivitis sicca (KCS). Not all dry eye symptoms are due to a dry eye and dry symptoms and findings do not necessarily worsen over time, and in fact may improve.

The symptoms are always the same—a sandy, gritty, burning feeling. Unfortunately, the causes of the dry eye are not. There are many different aetiologies of KCS.1 All too often we associate dry eye symptoms with a disorder of the tear film or tear secretion. In the article by Tsubota et …