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Dry Eye Diagnosis

Your Dry Eye Appointment at PVSC

What to Expect

These are the common tests and investigations that you need to have when you come for a consultation or a follow-up for a dry eye disease. We like to save you multiple visits to the office so these tests are arranged to get the most accurate information about your eyes in the most efficient way. Your eye health as well as your time is important to us.

Some of these tests are covered by OHIP but some are not. You’ll be informed of the cost of any testing that you would need before it’s done and you have the right to accept or refuse tests that involve extra cost. Insurance companies and ODSP/Ontario Works cover some of these tests.

How to Prepare

You have been referred to our office with symptoms that may be caused by ocular surface disease and/or meibomian gland dysfunction. Patients will have a series of tests done at the appointment. To accurately assess and determine the cause of your problem which will determine the most appropriate and effective treatment, patients must:

  • NOT use any form of artificial tears for a minimum 18 hours before the appointment.
  • NOT use any type of facial creams, lotions or makeup for a minimum of 18 hours before the appointment. Use of these things will affect the outcome of the analysis and give us inaccurate readings in your testing.
  • NOT wear contact lenses for a period of 48 hours before the appointment.

Diagnosis for Dry Eye

Below are a few tests that may be used to diagnose a patient with dry eye. At PVSC we offer Schirmer’s test.

Schirmer's Test

Schirmer’s test tells us whether the eye produces enough tears to keep it moist.

To do this, a special paper strip is placed inside the lower eyelid of each eye at the same time. Before the test, numbing eye drops are given to prevent the eyes from tearing because of the paper strips. Sometimes the test is done without numbing drops to test for other types of tear problems. The procedure may vary from patient to patient but most often, the eyes are gently closed for 5 minutes after which the paper strips are removed and are measured for moisture. More than 10mm of moisture is considered normal tear production. 

There are no risks associated with this test but you must NOT rub your eyes for at least 30 minutes after and do NOT put contact lenses for at least 2 hours after.

TearLab Osmolarity Test​

TearLab is the most accurate and objective test for diagnosing dry eye disease. TearLab generates an osmolarity number which tells us how concentrated the tears are. A high osmolarity is a hallmark sign of dry eye disease. Because this test is quantitative, fast, and easy it’s useful when monitoring patient response to treatment. 

LipiView

LipiView uses a technology called interferometry to capture high-definition images of the tear film’s oily layer and the meibomian glands located in the eyelids. These images provide valuable information about the quantity and quality of the oils in the tear film, as well as the health of the meibomian glands, the glands responsible for secreting the oily layer. 

By analyzing the images taken with LipiView, it’s possible to:

  • Evaluate the oily layer thickness and stability – thick and uniform oily layers are more effective at preventing tear evaporation.

  • Assess the meibomian gland function and determine if there are any blockages or abnormalities.

  • Aid in the diagnosis of dry eye disease and meibomian gland dysfunction.

  • Customize treatment plans (warm compresses, meibomian gland expression, medications, or other therapies aimed at improving tear film stability and meibomian gland function).