Diagnosing dry eye accurately requires more than listening to symptoms. We begin by talking with you about your symptoms, including when they are worst, what makes them better or worse, and how they affect your daily activities. We also review your medical history and any medications you take, since both can play a direct role in dry eye.
We then examine your eyelids, lashes, and eye surface under magnification to look for signs of inflammation, oil gland dysfunction, or damage to the cornea and conjunctiva (the clear membrane covering the white of your eye). We also consider other conditions that can overlap with dry eye, such as allergies, blepharitis (inflammation along the eyelid margin), eyelid mite infestations, and side effects from glaucoma drops, so that you receive care targeted to the actual cause.
Several targeted tests help us assess the quantity and quality of your tears. One common measurement involves placing a small paper strip under your lower eyelid for five minutes to see how much moisture your glands produce. We may also use tear break-up time testing to measure how quickly your tear film evaporates between blinks. Other tests that can help assess dry eye include tear osmolarity, which evaluates the salt concentration of your tears, and lipid layer imaging, which looks at the oily outer layer. Special dyes can temporarily highlight the microscopic scratches and roughness that chronic dry eye leaves on the cornea and conjunctiva, giving us a starting point to compare against at future visits.
After completing your evaluation, we determine whether you have aqueous-deficient dry eye, evaporative dry eye, or a mixed presentation, and whether your condition is mild, moderate, or severe. This classification guides everything about your treatment plan. Mild dry eye often responds well to simple measures at home, while moderate to severe cases typically require a combination of therapies to achieve meaningful, lasting relief.
