To evaluate the efficacy and safety of external nasal nerve stimulation auto-tear secretor ( iTEAR Muqin? ) in patients with dry eye. Methods From August to September, 2024, 20 adult subjects with dry eye were recruited. They were treated with iTEAR twice a day for a total of 28 days. Follow up was conducted on days 0, 7, 14, 28, and 42. Among them, the basic status before use and relevant indicators immediately after use were collected at the first 4 time points. The collected indicators included the ocular surface disease index (OSDI) questionnaire, tear meniscus height (TMH), fluorescein break-up time (FBUT), corneal fluorescein staining score, conjunctival enhanced fluorescein staining score, tear film lipid layer thickness (LLT) and tear ferning test. After treatment, subjects' satisfaction with iTEAR and experience were collected through questionnaires. Only data from the right eye were included for statistical analysis of clinical signs. Results On days 7, 14, 28, and 42, OSDI was decreased significantly compared with day 0 baseline (P<0. 01). FBUT was increased significantly compared with day 0 baseline (P<0. 01). Corneal fluorescein staining scores were decreased significantly compared with Day 0 baseline (P<0. 05). Conjunctival enhanced fluorescein staining scores showed a downward trend compared with Day 0 baseline, but the difference was not statistically significant (P>0. 05). There was no statistically significant difference between LLT and tear ferning test at each time point and the baseline on Day 0 (P>0. 05). Stratified analysis showed that those with higher baseline corneal fluorescein staining scores had a more significant improvement in tear film stability. Patients with lower TMH had a more significant improvement in ocular surface damage. During the treatment period, the subjects had no serious adverse reactions. The overall satisfaction with the treatment equipment was high (40% were satisfied and 60% were neutral). 90% of the subjects believed that the treatment was somewhat uncomfortable, but it was acceptable after adapting to it. Conclusions Extra nasal nerve stimulation can quickly and effectively improve the symptoms, tear film stability and ocular surface damage in patients with dry eye. The effect is sustainable after stopping treatment. The treatment has good acceptability and safety. These findings suggest that the stimulation of the external nasal nerve in the treatment of dry eye may trigger a sustained central nervous system regulatory mechanism