The TFOS DEWS II Epidemiology Report, published in *Ocular Surface* in 2017, provides an updated overview of the prevalence, incidence, risk factors, natural history, and impact of dry eye disease (DED). The report summarizes the findings from various epidemiological studies conducted over the past decade, with a focus on population-based studies. Key findings include: 1. **Prevalence**: The prevalence of DED ranges from 5% to 50%, with higher rates observed in Asian populations compared to Caucasians. The prevalence increases with age, and women have a higher prevalence than men, although this difference becomes significant only with age. 2. **Risk Factors**: Risk factors for DED include age, sex, race, meibomian gland dysfunction (MGD), contact lens wear, environmental exposures, computer use, diet, and genetic factors. MGD is a significant risk factor, and older age and female sex are consistently associated with increased risk. 3. **Natural History and Morbidity**: The natural history of DED is not well understood, and the impact of DED on vision, quality of life, work productivity, and psychological and physical well-being is considerable. Economic costs due to reduced work productivity are also significant. 4. **Economic Impact**: The economic burden of DED is substantial, particularly due to reduced work productivity. 5. **Geographical Mapping**: The report includes global mapping of DED prevalence, highlighting the lack of data from the Southern Hemisphere and the need for more studies in younger populations and regions like Africa and South America. 6. **Future Research Directions**: The report emphasizes the need for more studies to establish the prevalence of DED in different severity levels, incidence in various populations, and potential risk factors such as youth and digital device usage. Geospatial mapping could help elucidate the impact of climate, environment, and socioeconomic factors. The report also discusses the challenges in standardizing disease definitions and diagnostic criteria, which complicates the interpretation of epidemiological study results. It highlights the importance of future research to improve understanding and management of DED.The TFOS DEWS II Epidemiology Report, published in *Ocular Surface* in 2017, provides an updated overview of the prevalence, incidence, risk factors, natural history, and impact of dry eye disease (DED). The report summarizes the findings from various epidemiological studies conducted over the past decade, with a focus on population-based studies. Key findings include: 1. **Prevalence**: The prevalence of DED ranges from 5% to 50%, with higher rates observed in Asian populations compared to Caucasians. The prevalence increases with age, and women have a higher prevalence than men, although this difference becomes significant only with age. 2. **Risk Factors**: Risk factors for DED include age, sex, race, meibomian gland dysfunction (MGD), contact lens wear, environmental exposures, computer use, diet, and genetic factors. MGD is a significant risk factor, and older age and female sex are consistently associated with increased risk. 3. **Natural History and Morbidity**: The natural history of DED is not well understood, and the impact of DED on vision, quality of life, work productivity, and psychological and physical well-being is considerable. Economic costs due to reduced work productivity are also significant. 4. **Economic Impact**: The economic burden of DED is substantial, particularly due to reduced work productivity. 5. **Geographical Mapping**: The report includes global mapping of DED prevalence, highlighting the lack of data from the Southern Hemisphere and the need for more studies in younger populations and regions like Africa and South America. 6. **Future Research Directions**: The report emphasizes the need for more studies to establish the prevalence of DED in different severity levels, incidence in various populations, and potential risk factors such as youth and digital device usage. Geospatial mapping could help elucidate the impact of climate, environment, and socioeconomic factors. The report also discusses the challenges in standardizing disease definitions and diagnostic criteria, which complicates the interpretation of epidemiological study results. It highlights the importance of future research to improve understanding and management of DED.