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Dry eye is not just an irritating condition, it is a disease of the ocular surface, and it is important to assess patients with complaints of dry eye in a systematic and thorough manner, says , the dean of the School of Optometry at the University of Alabama at Birmingham.

In this video, Nichols describes the screening tools used at her clinic to make a successful diagnosis.

Following is a transcript of her remarks:

In our clinic, we have a specific dry eye clinic, but I like to think about the tests that you could do for dry eye screening, and what has been recommended in the Tear Film & Ocular Surface Society DEWS II report is that you do a symptom assessment, whether by interview or a survey like a DEQ-5 [5-item Dry Eye Questionnaire] or the OSDI [Ocular Surface Disease Index], cut points for those have been provided as screening tools. If they respond positively to having symptoms, you can do simple tests with your slit lamp. You can look for staining. You can also do a tear film break-up time, fluorescein. It's recommended that you do it noninvasive, but not everybody has a noninvasive way to measure tear film break-up time. If you have the opportunity to do osmolality, you could do that as well.

The presence of symptoms and any one of those three abnormal tests is a positive for screening for dry eye, meaning then you need to go further and try and sort through if it's meibomian gland related or aqueous deficient. That's simple enough, so you don't need a whole lot of fancy equipment to make an initial diagnosis of dry eye and take care of your patient if you're just starting out.

I like to say that it's ask, look, and then do something. So you just keep it really simple. I used to recommend all the fancy equipment, which is really great; it helps you really dive into what could be going on. But if you want to start, keeping it simple, anybody can do it. We have a slit lamp at our disposal, which is very useful. If you don't want to measure a Schirmer test to figure out if they have aqueous deficiency, then you can look with your slit lamp at tear meniscus height and make an assessment. Your slit lamp is your most valuable tool.

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