Using Medical History to Diagnose Chronic Dry Eye

Reviewed by: HU Medical Review Board

Chronic dry eye, or “dry eye,” is a disease of the surface of the eye. The condition can happen when your eye does not make enough tears or there is an issue with the tears that are made. Dry eye may also be called dry eye syndrome (DES), dry eye disease (DED), or keratoconjunctivitis sicca.1

Studies have found that nearly 16.5 million adults in the United States have been diagnosed with chronic dry eye. Plus, there are about 6 million more people who have symptoms but have not been diagnosed with the condition.2

A detailed, accurate medical history and physical exam are needed to get the right diagnosis of dry eye disease. While your eye doctor will be the person taking note of your health history and performing the exam, you play an important and active role in the process.

Detailed description of symptoms

Describing your medical history as accurately and detailed as possible ensures your doctor gets all the information needed to treat your symptoms. This may not be easy. Do your best to remember when your symptoms or discomfort started. What made you come in to see the doctor? How would you describe your symptoms? Is there anything that makes your dry eyes better or worse?3

Your history of disease, illness, or surgery

Describe and list any diseases or illnesses you have had, even if they happened in childhood. Be sure to include any trauma or injury to your eye, which can also lead to problems with dry eyes.3

Health history of your immediate family

The health status of your immediate family members may offer important clues about your current health. Your doctor may ask questions about family medical history for this reason.3

Your environment and job

Because chronic dry eye symptoms may be caused or made worse by environmental factors, this is an important part of your medical history. Extended computer screen time, exposure to chemicals, or living in a dry climate are some of the ways the environment may contribute to dry eyes.1-4

Helpful screening tools

One tool your eye doctor may use is the ocular surface disease index (OSDI). The OSDI is a 12-question survey that is used to help diagnose dry eye disease. The survey focuses on the physical symptoms you are experiencing. The impact of dry eye on activities of daily living – such reading, driving at night, looking at a computer screen or TV – are assessed in the survey.5

Physical exam

Your eye doctor will look at your eyes and eyelids as part of the physical exam during your visit. Your doctor will use a variety of tests and tools to perform your exam.

Slit lamp examination

A slit lamp is a microscope with a bright light. Your doctor uses this to see the parts of your eye up close. The slit lamp is a key device to finding eye disease and assessing the overall health of your eye.6

Vision test

A visual acuity test is a simple vision test that checks how well you can see. Your doctor does this using a Snellen chart, a standardized chart with various capital letters in different sized fonts. The Snellen chart allows someone to go to any eye care provider or doctor and get the same vision test results.7

Eyelid position

Many times, dry eyes may happen because of problems with your eyelids. Glands that help with tear production are found in your eyelids, along with nerves. If your eyelids do not close properly, dry eye symptoms may develop. The position of your eyelids will be assessed during the physical exam.8

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