Abstract: Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to ocular surface. It is accompanied by increased osmolarity of tear film and inflammation of the ocular surface. Current studies have shown that inflammation may play an important role in the pathological damage of dry eye. This article reviews how inflammation in dry eye leads to potential damage to the tears and ocular surface. Evidence for inflammatory mechanisms accounting for potential damage to the tears and ocular surface will be provided from the following aspects: tear hyperosmolarity, altered expression of mucins, disruption of the structure and function on keratoconjunctival epithelium, lacrimal gland and meibomian gland.  (Int Rev Ophthalmol, 2013, 37: 307310)