Practical Office-Based Screening and Diagnostics

A standardized approach to dry eye testing is crucial to diagnose the presence and severity of dry eye and monitor the success or failure of treatment. This is especially important as the severity of dry eye guides the appropriate course of management. Current international guidelines recommend use of standardized and validated questionnaire to record symptoms of dry eye. Routine testing should include a Schirmer test, noninvasive tear film break-up time, and assessment of corneal staining with fluorescein. Assessment of the lid margin, meibomian glands, and the cornea should also be performed. A number of additional diagnostic instruments such as tear interferometry, meibography, and tear osmolarity may be useful adjuncts to standardized testing.