Diagnostic Tools and Techniques

With an aim to better educate health care providers about Dry Eye and related diseases, The Tear Film and Ocular Surface Society (TFOS) hosted the 2007 International Dry Eye Workshop (DEWS). The report by the Diagnostic Subcommittee included 88 diagnostic tests and several methodologies for diagnosis.

In 2011, TFOS published the International Workshop on Meibomian Gland Dysfunction reports, including an updated report focusing on the diagnosis of MGD and related diseases.

We have also prepared information about diagnostic tools that are sometimes commonly used, and which you might encounter, during a Dry Eye exam at a doctor’s office.

Although there are many different ways to test for Dry Eye and related co-morbidities, some tests are superfluous, providing evidence for something that may already be obvious. Other important tests are not always used, may be performed improperly, or may be used for the wrong reasons.

Diagnostic Tools

Allergy Tests
Confocal Microscopy
Conjunctival Impression Cytology for Goblet Cells’ Count
Corneal and Lid Margin Sensitivity (Aesthesiometry)
Corneal and Ocular Surface Staining
Do Eyes Close When the Head is Tilted Back?
Detecting Demodex Mites
Establishing Severity of the Disease
Fundus Ophthalmoscopy
Intraocular Pressure (IOP)
Korb Meibomian Gland Evaluator™ (MGE)
LipiView® II
MMP-9 Levels
Pressing on Eye Lids
Schirmer Tests
Sensitivity Tests
Slit Lamp Examination
Tear Film Break-Up Time (TFBUT or TBUT)
Tear Film Interferometry
Tear Film Osmolarity
Test Limitations
Visual Acuity
Which Test is Best