How to examine a dry eye patient.
Last week, I was doing my normal dry eye exam and asked the patient to close her eyes so I can examine them. She said confused, "wait, why close them!?"
She brought up a great question.
Q: Why do I examine a patients eyes when they are closed?
A: Because the eyelids play a huge role in dry eye disease.
I need to look at the lids and lashes to determine a variety of things:
🔸do the lids close properly (many don't!)?
🔸is there excessive bacteria on the lashes?
🔸are there demodex mites present on the lashes?
🔸are there extra blood vessels growing on the lash line suggesting inflammation?
🔸does the oil properly flow out of the oil glands?
Who knew dry eye disease had so much to do with the lids!