Your Dry Eye Evaluation
A Closer Look at What’s Behind Your Symptoms
Our treatment approach begins with an extensive dry eye evaluation utilizing the Oculus Keratograph 5M. This sophisticated technology helps identify the contributing factors, along with your health history and exam, allowing us to customize a treatment protocol based on your specific needs. Similar symptoms don’t always have the same cause. Your work environment, screen time, contact lens wear, medications, and certain autoimmune conditions can help us see the bigger picture. We take time to learn when your eyes are bothering you, how symptoms affect your daily activities, and what you’ve already tried.
The 5M obtains measurements for the water, oil, and mucus layers of the tear film, as well as any offenders that can be disrupting the tear film functionality. The data collected along with a thorough evaluation by our dry eye specialist will be analyzed and used to create a personalized treatment approach. Throughout your journey to better eye health the doctor will re-evaluate with the 5M imaging to be sure progress is being made.
Types of dry eye
- Aqueous Deficient (Water) – Also known as Keratoconjunctivis Sicca. When your lacrimal gland does not make enough tears. Common reasons include: medical conditions (diabetes, RA, Sjogren’s and thyroid disorders) and medications.
- Lipid Deficient (Oil) – Also known as Meibomian Gland Dysfunction (MGD). When your tears evaporate too quickly. Common reasons include: inflammation of the eyelid (blepharitis) or rosacea.
- Blink Inadequacy – Partial or infrequent blinking. Common reasons include: environmental offenders (smoke, wind, dry air), eyelid structure that doesn’t allow for proper blinking mechanics, or prolonged screen time.
- Mixed – a combination different causations
What We Examine – and Why It Matters
Tear-Film Stability
Your tear film should provide a smooth, protective surface between blinks. Testing such as NIKBUT helps us determine how long the tear film remains stable after your blink. This helps us understand whether tear-film instability may be contributing to irritation or fluctuating vision.
NIKBUT: Noninvasive keratograph tear break-up time.
Oil-Gland Structure and Function
The meibomian glands inside your eyelids supply oils that help slow tear evaporation. Meibograpghy lets us examine the structure, including changes in shape or areas of gland drop-out. We also assess the gland openings and the oils they release. When these glands become blocked or don’t function properly, less oil reaches the tear film, allowing tears to evaporate faster. Together, imaging and examination help us understand both gland health and function.
Meibography: Imaging the meibomian glands inside of the eyelids.
The Eye’s Surface
Diagnostic dyes help highlight areas of surface irritation or damage that may otherwise be difficult to see. We assess the location and pattern of these findings alongside your symptoms and other test results to evaluate the health of your eye’s surface and how well your tear film is protecting it.
Stains: Fluroscein dye with blue filter.
Understanding Your Findings and Personalizing Your Treatment Plan
Once your imaging and exam are complete, we review the finding with you and explain how they guide your treatment options. Your results may show reduced tear production, tears that evaporate too quickly or a combination of both. Eyelid conditions and incomplete blinking may also contribute. We will discuss practical adjustments to habits and environmental factors, such as makeup use, fans blowing toward you at night, and prolonged screen time. If your findings and health history suggest a broader concern, we may recommend additional testing or coordination with another healthcare provider, such as a rheumatologist or sleep medicine specialist.