The integrity of tear fluids and ocular tissues is essential for expressing abundant antioxidants to maintain redox homeostasis on the ocular surface. 1 As a result of the intense burden of free-radical stress in the first-line barrier tissues, oxidative/antioxidative imbalance has been proposed as a central pathological factor in the pathogenesis of dry eye disease (DED). 1 A range of antioxidant defenses are found on the ocular surface, such as tears containing lactoferrin and S100A proteins and enzymes such as antioxidants like superoxide dismutase, peroxidase, catalase, and mitochondrial oxidative enzymes.

2 An imbalance between the level of reactive oxygen species and the protective enzymes leads to oxidative damage and inflammation. 2 This animated infographic highlights the association between oxidative/antioxidative imbalance and DED.