Pitfalls of dry eye disease diagnosis
Listening to patients is key in diagnosing dry eye disease


Roibeard O’hEineachain
Published: Sunday, March 1, 2020
Prof Marc Labetoulle
He noted that the first step in the examination is to listen to the patient’s description of their dry eye symptoms. That involves having the patient complete an OSDI questionnaire while still in the waiting room and then hearing the patient’s spontaneous complaints as well as information about risk factors.
The second step is examination of the eyes themselves, starting with slit-lamp examination, first without fluorescein to determine tear break-up time. Lid evaluation should follow, to determine the main mechanism of DED, whether it is aqueous deficiency or meibomian gland dysfunction. One should also be careful not to miss signs of other ocular surface diseases such as limbal keratitis, he pointed out.
It is also essential to get an idea about the level of tear secretion. Research shows Schirmer test and phenol red thread tests are reliable, and assistants can be trained to perform them effectively. Tear meniscus measurement can be a practical alternative, although there are precisely validated normal values for the parameter.
Once these tests and examinations are complete the prescription may be formulated that specifically addresses both the patient’s symptoms and the underlying disease, Prof Labetoulle said.
Tags: ESCRS Marrakech 2020
Latest Articles
ESCRS Today 2025: Happy Anniversaries!
ESCRS celebrates milestones with pioneers in IOLs, LASIK, femtosecond lasers, and corneal transplantation.
ESCRS Today 2025: A Congress for Everyone
From YOs to families, the ESCRS Annual Meeting embraces full participation through inclusivity.
Beyond the Numbers
Empowering patient participation fosters continuous innovation in cataract surgery.
Thinking Beyond the Surgery Room
Practice management workshop focuses on financial operations and AI business applications.
Aid Cuts Threaten Global Eye Care Progress
USAID closure leads retreat in development assistance.
Supplement: ESCRS Clinical Trends Series: Presbyopia
Debate: FS-LASIK or KLEx for Hyperopia?
FS-LASIK has more of a track record, but KLEx offers advantages.
Four AI Applications Ready for Practice
Commercial offerings may save time, improve practice and research.
Perioperative Medication Regimens for Cataract Surgery
Randomised controlled clinical trial results provide evidence-based guidance.