Diagnosing Dry Eye

Dry eye is often diagnosed by patient symptoms and complaint. For that reason any quality dry eye work up begins with a thorough medical and eye history but should also include specific dry eye diagnostic tests that are not part of a comprehensive eye healt exam. Symptoms of dry eye include:

  • A gritty sensation
  • A feeling of a foreign body or sand in the eye
  • Blur or hazy vision
  • Dry eyes
  • Tired eyes
  • Red irritated eyes
  • Blurry of vision
  • Pain


A comprehensive eye exam is essential both as a baseline for future examination and to assess any impact of dry eye or ocular surface disease. Careful examination of the external eye, focusing on the ocular surface is performed with a biomicroscope, which is also referred to as a slit lamp. A number of dyes or “stains” are used with special filters to highlight any surface abnormalities. These include fluorescein and lissamine green stains.

 Breakup time (BUT) – the time it takes for the tear film to become unstable is an important indicator of tear quality and dry eye. Breakup time is most accurately measured without fluorescein using special instruments such as the Oculus Keratograph 5M.

Oculus Keratograph 5M

Because meibomian gland dysfunction is so critical to normal tear function, meibomography is a valuable means of evaluating the meibomian glands structure. The Oculus Keratograph 5M provides meibomography, tear menisus height, lipid layer analysis and objective non-invasive tear breakup measurement. Patients who come to the Dry Eye Center of West Michigan will have a full dry eye workup and evaluation of the ocular surface using the Keratograph 5M.