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? ⁠