<p><strong>Background:</strong> Dry eye disease (DED) is a common condition affecting millions worldwide, causing vision problems, discomfort and decreased quality of life. Many factors cause this local ocular surface disease and involve multiple mechanisms. Effective management and care of DED is crucial to reduce associated risks.<br /><strong>Aim:</strong> This study aimed to evaluate practitioners’ DED knowledge, clinical protocols and barriers experienced in the management of DED.<br /><strong>Setting:</strong> This study targeted three levels of spheres – primary, secondary and tertiary – in Durban, KwaZulu-Natal (KZN), South Africa.<br /><strong>Methods:</strong> An exploratory, descriptive qualitative design was used for this study. Participants were clinical eye care providers from the McCord Provincial Eye Hospital and its referral catchment facilities in South Africa. Three focus group interviews were conducted with 16 participants, lasting 60 min 80 min.<br /><strong>Results:</strong> Thematic analysis identified five major themes: eye care services, dry eye knowledge, diagnosis, management, and barriers and challenges. A key finding reported was that facilities lacked appropriate equipment to examine, diagnose and manage DED. Further, limited DED medicine availability, understaffing and inadequate practitioner knowledge of DED management were challenges cited in DED diagnosis and management.<br /><strong>Conclusion:</strong> Understanding the complexity of factors involved in diagnosing and managing DED will guide future facility planning, practitioner education and eye health policy development. It is recommended that facility leadership engage with respective health professions to identify and mitigate barriers to DED diagnosis and management.<br /><strong>Contribution:</strong> This article highlights challenges to DED management at the represented KZN health facilities and the need to upskill health practitioners and provide the necessary equipment to improve service delivery.</p>