Diagnostic Testing for Dry Eye
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1) Corneal and Conjunctival Staining:
2) Tear break-up time (TBUT)
3) Schirmer's Test: A small paper strip with rulers printed along their length are placed inside the lower eyelids (inside the inferior conjunctival fornices) after the eyes are numbed with a topical anesthetic drop. The strips are removed after 5 minutes and the amount of tears produced in that time is read off of the strips (and measured in millimeters). Interpretations can vary but usually < 10mm of tear production in 5 minutes is suggestive of some form of dry eye.
4) TearLab: This in office test measures tear osmolarity. The test is a relatively painless and quick (seconds) and can be performed by an ophthalmic technician. Increased osmolarity indicates dry eye. A score over 300 mOsm/L or an intereye difference greater than 8 mOsm/L indicates dry eye.
5) LipiView: An interferometer is a noninvasive instrument that measures the amount of oil in the tear film. The measurements are obtained through images of the tear film that are captured over a 5 minute period.
Am J Ophthalmol. 2011 May;151(5):792-798.e1. doi: 10.1016/j.ajo.2010.10.032. Epub 2011 Feb 18. "Tear Osmolarity in the diagnosis and management of dry eye disease." Lemp MA1, Bron AJ, Baudouin C, Benítez Del Castillo JM, Geffen D, Tauber J, Foulks GN, Pepose JS, Sullivan BD.
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