How is it Diagnosed?
Dry Eye Disease, or Keratoconjunctivitis Sicca, is diagnosed through a combination of
symptom evaluation and clinical tests. A detailed patient history is crucial, focusing on
symptoms like burning, grittiness, photophobia, and blurred vision. Tools like the Ocular
Surface Disease Index (OSDI) questionnaire help quantify symptom severity.
The clinician then examines the eyes for signs of dryness. Slit-lamp biomicroscopy is
used to inspect the ocular surface, tear film, and eyelid margins. The Schirmer’s Test
measures tear production by placing a paper strip under the lower eyelid for five
minutes—values below 10 mm suggest decreased tear production. Tear Break-Up Time
(TBUT) evaluates tear film stability; a shorter TBUT indicates faster evaporation.
Fluorescein, lissamine green, or rose bengal dyes are used to detect damage to the
cornea and conjunctiva, highlighting areas of dryness or epithelial disruption. Meibomian
gland function is also assessed, especially in evaporative dry eye.
Advanced diagnostics may include tear osmolarity testing and ocular surface
inflammation markers like MMP-9. Diagnosis is often multifactorial, distinguishing
between aqueous-deficient and evaporative dry eye or a combination of both. Accurate
diagnosis is essential for targeted treatment such as artificial tears, anti-inflammatory
drops, punctal plugs, or lifestyle changes.