Dry eyes are a frequent feature of routine ophthalmic clinical practice, but also form one of the commonest ocular manifestations of rheumatological disease. The spectrum of dry eye disease ranges from mild tear film instability through to severe dry eye which can threaten the integrity of the ocular surface and even lead to ocular perforation. This article discusses the disease pathophysiology and clinical manifestations of dry eye disease and also explores methods of diagnosis and assessment of dry eye. Current and emerging treatment modalities are also discussed, including the different types of ocular lubricants, the role of topical cyclosporine in the management of associated ocular inflammation, and mechanical measures such as plugging of the lacrimal punctum. © 2011 Bentham Science Publishers Ltd.