5 Steps to Diagnosing Dry Eyes

Are you all familiar with the discomfort of dry eyes? The irritation, redness, and gritty sensation seem like an endless cycle! If so, you’re not alone. Studies show that over 40% of India’s urban population will have symptoms of dry eyes by 2030. Severe eye dryness, or dry eye syndrome, can impact their daily lives.

In this blog, we’re looking into the different ways a dry eye doctor will examine your eyes during an appointment so that they can suggest the best dry eye treatment for you.

Step 1: History of complaints

When you visit an eye doctor or ophthalmologist, they will ask you about your symptoms in detail. They want to know if you have any dryness, irritation, or redness or your vision changes. It’s important to describe your symptoms clearly, including how long they have bothered you and if any specific things make them better or worse. 

This detailed history-taking also includes a questionnaire – the Ocular Surface Disease Index (OSDI) – evaluating how uncomfortable your eyes have been due to dry eyes.

Step 2: Comprehensive Eye Examination

Your journey to a dry eye diagnosis begins with a comprehensive eye examination. During this evaluation, your eye doctor will assess your overall eye health by examining your ocular surface, the opening of the glands on the lid margin, and look out for signs of allergies or infections/inflammation of the lids (blepharitis) They’ll also discuss your symptoms, medical history, and lifestyle factors that may contribute to dry eyes.

Step 2: Tear Film Evaluation

Your dry eye doctor may evaluate the tear film to understand your tear production and quality better. The Tear Break-Up Time (TBUT) test is a quick and painless method to determine the stability of your tear film

A. Your dry eye doctor will apply a small amount of a harmless dye to the surface of your eye. This dye mixes with your tears and makes it easier to see what happens next.

B. You’ll be told to blink a few times. This distributes the dye evenly across the surface of your eye.

C. The eye doctor uses a microscope called a slit lamp to examine the tear film on the surface of your eye. They watch for changes, such as small dry patches on the eye or areas where the tear film breaks into tiny droplets. 

D. They measure the time it takes for your tears to break up or disappear from the surface of your eye. This is called the Tear Break-Up Time (TBUT).

 A shorter TBUT time may indicate that your tears evaporate too quickly, leading to dry eye symptoms.

Step 3: Schirmer's Test

During the Schirmer test, your eye doctor will place a small strip of filter paper under your lower eyelid and wait a few minutes. The strip absorbs your tears, and its wetness is measured. This helps determine if your tear glands are producing an adequate amount of tears.

Step 4: Meibomian Gland Evaluation

The Meibomian glands, located along the eyelid margins, produce the oily layer of the tear film, which prevents tears from evaporating too quickly. Dysfunction of these glands is one of the most common causes of Dry Eye Syndrome. 

Your eye doctor may evaluate the Meibomian glands using specialized imaging devices to assess the quantity and quality of the gland secretions, which is what causes severe eye dryness. This diagnostic tool is called meibography. 

A. During a meibography, your eye doctor will use a specialized imaging device to take detailed pictures of your Meibomian glands.

B. The imaging device is usually placed near your eyelids, capturing high-resolution images of the glands.

C. These images provide a clear view of the Meibomian glands and allow the doctor to assess their structure and condition.

D. By examining the images, the doctor can identify any blockages, inflammation, or atrophy (shrinking) of the glands, often associated with Meibomian Gland Dysfunction (MGD).

By understanding the state of your Meibomian glands through meibography, your dry eye doctor can recommend the best dry eye treatments to improve the health and function of these glands. This will help relieve your dry eye symptoms and improve the overall health of your eyes.

Step 5: Interferometry

Using an interferometer, dry eye specialists can examine the tear film to check the thickness of the oily layer or lipid layer of the tear film. People with altered lipid layers may be more prone to dry eye symptoms. 

When To See A Dry Eye Specialist?

If you are currently dealing with persistent symptoms or discomfort related to dry eyes, we strongly advise you to make an appointment with a dry eye specialist to ensure a proper evaluation and appropriate treatment. They will be able to assess your condition thoroughly and provide personalized care to address your unique needs.

To sum it up: 

Once the diagnostic tests are complete, your eye doctor will analyze your symptoms, clinical findings, and test results to determine if you have Dry Eye Syndrome and identify the underlying causes of your condition. Remember, understanding the diagnosis is the first step towards finding relief with the best eye treatment for dry eyes.