How Is Dry Eye Syndrome Diagnosed?

The Dry Eye Exam

Our dry eye doctor will also conduct an in-depth assessment of indicators for other diseases and health problems which might be contributing to your dry eyes. We then develop a personalized treatment plan based on what we find.

In every patient questionnaire, we ask if you are suffering from any of the typical symptoms of dry eyes. Do your eyes feel gritty? Sore? Do you feel like something is in your eye or that you just don't seem to have any tears? If you report symptoms of dry eye or appear to exhibit those symptoms, then we recommend beginning the dry eye exam process, which is quick, easy, and painless.

Oculus Keratograph

What patients find fascinating about the Oculus Keratograph is the sheer amount of information that this technology can produce in such a short amount of time when being tested. It not only measures tear break-up time, ocular irritation by rating the redness of the conjunctiva or white part of the eye, evaluating the thickness of the event of the tear layer or the oil layer of the tears as well as the ability to take pictures of the meibomian glands. This is the most fascinating thing to bring up pictures of the patients’ glands in the exam room and grade them on a scale so that they can see exactly why they are having the symptoms they have from meibomian gland dysfunction. Oftentimes, we hear patients say “Oh my goodness, those are my glands!”

Educating patients in the exam room is much easier with all of these indicators to the patient. It also measures tear breakup time which is the amount of time between blinks before the tear layer starts to dissipate. By far, the most quantitative technology available to test for dry eye.

Tear Lab - what exactly goes into healthy tears?

The first thing we want to check is the stability of the tear film. We use TearLab to test the osmolarity of your tears― that is, the relative concentrations of salts, water, and lipids (fatty oils). These lipids are produced by the meibomian glands. Most cases of dry eyes occur where there is a problem with these glands. They could be blocked, atrophied, or otherwise damaged. If your tears evaporate too quickly (which causes burning), it's usually caused by a lack of these lipids.

A strong imbalance between the osmolarity of one eye vs. the other is a strong indication of dry eye disease.

InflammaDry

Another tool in the arsenal of our dry eye experts is InflammaDry, a specialized diagnostic tool which measures whether or not a patient has elevated levels of MMP-9 in their tears from the inner lining of the lower eyelid. MMP-9 is a protein which indicates inflammation—fairly common for anyone suffering from dry eyes.

Dr. Peters will typically prescribe steroids in order to get the eye inflammation under control.

Fluorescein Dry Test 

Our dry eye doctor will also test your tear breakup time. Sometimes, tears don't last long enough to work effectively. In order to test for this, we use a fluorescein orange dye to test the breakup time (as well as any other corneal diseases, conditions, or foreign bodies). Using a small blotting paper, the optometrist will lightly touch your eye. As you blink, the dye spreads and gently coats the tear film covering the cornea. Using a blue light (the dye is orange), any problems will be revealed to the eye doctor by emitting a green color.