Dry eye syndrome (DES) affects a significant proportion of the population, and although it is more common in the elderly, this eye condition is increasingly occurring at younger ages. Common symptoms include ocular dryness, a foreign-body sensation, burning, itching, hyperaemia and sensitivity to light. Risk factors include, amongst others, female sex, medicines with anticholinergic activity, hormonal influences and environmental factors. Dry eye syndrome has been classified into aqueous deficient dry eye and evaporative dry eye, but due to the interlinked nature of the causes, it is difficult to distinguish between the two. Dysfunction of the lacrimal functional unit ultimately leads to DES. Treatment of DES should follow a step-wise approach in accordance with the level of severity.