Is that really the question or do eye symptoms lie? For those of us who see patients on a regular basis, how many times a day do we hear the recurring complaint, “Doctor, my eyes feel so dry…they itch, they burn, they feel constantly irritated”? As doctors we must ask, with a sense of wonder, do all of these patients really have dry eyes? Are we currently in the midst of a global epidemic of ocular dryness that has caught us unawares and unprepared? Our patients are telling us something when they describe their symptoms, but in the process are they also unintentionally misleading us? Are their eyes truly dry, and if they are not, is it possible for us to tell the difference? Lee et al in the December issue of the BJO have done a superb job of documenting the prevalence of dry eye symptoms in a village population in Sumatra, Indonesia.1 Their statistical approach is impeccable. Using a one stage cluster sampling procedure, they randomly selected 100 households in each of five rural villages and one provincial town in Riau Province over a 3 month period in 2001. Demographic, life style, and medical data were collected from 1058 participants and dry eye symptoms were assessed using a six item questionnaire. The questions were, essentially, do your eyes ever feel dry, do you experience grittiness, burning, or redness, do you have crusting, …