In this podcast, the first of three dedicated to dry eye disease (DED), Prof. Stefano Barabino (Italy), Prof. Maurizio Rolando (Italy) and Dr Preeya Gupta (USA) discuss how physicians first came to understand that dry eye is a disease rather than just a symptom, what is happening at the ocular surface in the vicious cycle of DED, and the disconnect between signs and symptoms in DED. They will also consider the link between cataract surgery and DED, and the increasing prevalence of DED – especially in younger people – associated with increased use of smart phones and other screens.