2007 DEWS diagnostic methodology tables

The 2007 Dry Eye Workshop Diagnostic Methodology Committee included several diagnostic methodologies developed by different doctors and organizations, as well as a table of methodologies in development.

An example of one diagnostic methodology table in the report grades test invasiveness, increasing from A to L. (See below). The authors recommended that some time interval should be left between tests, and that tests selected would depend on facilities, feasibility, and other operational factors.

Diagnostic Methodology Table

Group Assessment Technique
A Clinical history Questionnaire
Symptoms e.g.: dry eye Symptom questionnaire
B Evaporation rate Evaporimetry
C Tear stability Non-invasive TFBUT (or NIBUT)
Tear lipid _ lm thickness Interferometry
Tear meniscus radius/volume Meniscometry
D Osmolality; proteins lysozyme; lactoferrin Tear sampling
E Tear stability Fluorescein BUT
Ocular surface damage; Grading fluorescein;lissamine green
Meniscus, height, volume Meniscus slit profile
Tear secretion turnover Fluorimetry
F Casual lid margin oil level Meibometry
G Index of tear volume Phenol red thread test
H Tear secretion Schirmer I with anesthesia
Schirmer I without anesthesia
Reflex tear secretion Schirmer II (with nasal stimulation
I Signs of MGD Lid (meibomian gland morphology)
J Meibomian gland function MG expression
Expressibility of secretions
Meibomian physicochemistry Oil chemistry
K Ocular surface damage Rose bengal stain
L Meibomian tissue mass Meibography

Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007)
Ocular Surface
2007 Apr;5(2):108-52.
View the full report