When a patient comes to the office for a dry eye examination, they can expect to see photographs and videos of their eye and talk about their eyes in ways they've likely never done before. We really look at the whole person and what is contributing to the dry eye disease. We start with an extensive history including any systemic conditions the patient may have, medications they're on, their work environment, and even things like history of contact lens wear or makeup use. Many, many things contribute to dry eye disease.
We try to do a thorough evaluation of the person as a whole to figure out what is the contributing factor here. Then we do a really thorough examination of the ocular surface itself. We look at the eye specifically as it relates to tear production.
I'm looking at how fast the patient's tears evaporate as that's one of the biggest causes of dry eye. A patient may not be producing enough oil in their tears and that causes the tears to evaporate very quickly.
We look at that oil layer using infrared photography which is a really neat tool that we have and that the patient can actually see any damage that may have already taken place within their eyelids and is contributing to the symptoms that they're experiencing.
From these tests, we can see if the patient has enough of all those independent layers that comprise the tear film, where does the deficiency lie, and base our treatment plan around where the deficiency is. We're also using different different stains that go in the eye that show patterns of inflammation.
Depending on stage and calls of dry eye, we see inflammation in different parts of the eye. Sometimes that's corneal staining, inflammation and blood vessel growth on the eyelid margin, puffy red eyelids, or red eyes in general.
We're really just looking at the eye as a whole to identify those areas of inflammation and target treatment towards those areas specifically.