Ocular surface and tear diseases are among the most common and significant ocular conditions affecting eye health. In recent years, research and clinical diagnosis and treatment of ocular surface and tear diseases have rapidly developed in China, but numerous challenges remain. Breakthroughs in medical artificial intelligence (AI) offer new methods and approaches to address these difficulties. This article, based on the current state of AI applications for ocular surface and tear diseases in China and the major challenges, outlines future directions for progress. With the construction of shared multimodal databases, development of AI foundational models, improvement of AI evaluation systems, promotion of AI for comprehensive disease management throughout the entire lifecycle, and training of multidisciplinary talents, significant advances of the application of AI in the diagnosis and treatment of ocular surface and tear diseases would be achieved.