Dr. Griffiths and her staff are the best in the business. Their care and professionalism are outstanding. If you’re looking for excellent eye care, look no further!
Nicole Baker Fulgham
What Is a Dry Eye Evaluation?
Preparing for Your Dry Eye Evaluation
A little preparation before your visit helps us get the most accurate results and make the best use of your appointment time. The steps below are straightforward and make a real difference in the quality of your testing.
Bring a complete list of all prescription and over-the-counter medications you take, including vitamins and supplements. If you use any eye drops, artificial tears, or ointments, bring the bottles or write down the exact product names and how often you use them.
A brief summary of any recent health changes or prior eye surgeries is also helpful, as this gives our eye doctors important context about your overall eye history and health picture.
Many systemic medications reduce tear production or change tear quality, so a complete medication history is essential. Blood pressure drugs, antihistamines, decongestants, hormone replacement therapy, and certain antidepressants are especially important to mention.
- Any autoimmune or inflammatory conditions you have been diagnosed with
- Allergies to medications or preservatives found in eye drops
- Recent changes in your general health or any new diagnoses
- Family history of dry eye or autoimmune disease
We typically ask you to avoid wearing contact lenses for at least 24 hours before your evaluation, since lenses can temporarily change the eye surface and affect test results. Rigid gas permeable lenses may require a longer break than soft lenses, so contact our office ahead of time if you are unsure.
Avoid eye makeup on the day of your appointment. Mascara, eyeliner, and eyeshadow can interfere with imaging and gland assessments, and we may need to clean your eyelid margins for accurate measurements. Our team will give you specific instructions when you schedule your visit, including whether to pause artificial tears or ointments for a short time before testing.
What to Expect During Your Dry Eye Evaluation
Each step of your evaluation builds a clearer picture of your tear health and eye surface condition. Our eye doctors use a combination of clinical observation and specialized testing to gather the information needed to guide your care.
We begin by examining your eyelids, eyelashes, and the skin around your eyes using a slit lamp, which is a specialized microscope used to closely inspect the structures of the eye. We check for signs of inflammation, redness, swelling, or crusting along the eyelid margins.
We also evaluate how fully your eyelids close and how often you blink, because incomplete closure and infrequent blinking both accelerate tear evaporation. The position and overall health of your eyelids play a central role in keeping your tear film stable.
One common test measures how long your tear film stays intact before it breaks apart, which is known as tear breakup time. We may apply a small amount of fluorescein dye, a safe diagnostic agent that glows under a blue light, and then observe how quickly the tear film develops gaps after blinking.
- A stable tear film typically holds together for around 10 seconds or longer, though this varies by method and individual
- Early breakup often suggests poor tear quality or problems with the oil layer
- This test is quick and painless
- Results are always interpreted alongside your symptoms and other findings, not in isolation
To measure how much tear fluid your eyes produce, we often use the Schirmer test. A thin strip of special filter paper is gently placed under your lower eyelid for about five minutes to measure moisture output. The test may be done with or without numbing drops depending on our clinical approach.
The paper absorbs your tears, and we measure how far moisture travels along the strip. Low readings suggest reduced aqueous, or watery, tear production. This test can feel slightly ticklish but is not painful.
The meibomian glands are small glands in your eyelids that produce the oily outer layer of your tears, which slows evaporation. We examine these glands using specialized imaging that reveals whether they are blocked, damaged, or have lost tissue over time, a process called gland dropout.
We may also gently press on your eyelids to assess whether the glands release clear, thin oil or cloudy, thickened secretions. Blocked or dysfunctional meibomian glands are among the most common causes of evaporative dry eye.
- Meibography imaging to visualize gland structure and identify dropout
- Gland expressibility grading and secretion quality assessment
- Evaluation of lid margin changes and blood vessel irregularities
- Checking for signs of Demodex mites or anterior blepharitis
We use safe diagnostic dyes to reveal any damage on the surface of your eye. Fluorescein dye highlights damage on the cornea, the clear dome at the front of the eye, while lissamine green reveals damage on the conjunctiva, the white part of the eye. These dyes temporarily stain areas where surface cells are dry, damaged, or missing.
- Corneal staining can indicate significant dryness that requires prompt treatment
- Conjunctival staining may reflect inflammation or exposure-related damage
- The pattern and location of staining help us identify the root cause
- Advanced imaging can capture detailed photos for tracking changes over time
Your vision may be briefly blurry from drops or dye used during testing. This is completely normal and clears quickly on its own.
Understanding Your Dry Eye Evaluation Results
Once testing is complete, our eye doctors review each result in the context of your full clinical picture. Understanding what your findings mean helps you take an active role in your care and set realistic expectations for treatment.
We classify dry eye into severity levels based on your symptoms, test results, and surface findings. Mild dry eye typically involves occasional discomfort and minor changes in tear quality, often manageable with lifestyle adjustments and lubricating drops.
Moderate dry eye causes more frequent symptoms that interfere with daily tasks and may require prescription treatment or in-office therapy. Severe dry eye involves significant surface damage, persistent discomfort, and a higher risk of complications, requiring intensive treatment and close monitoring.
Your results will show whether you have evaporative dry eye, aqueous deficient dry eye, or a combination of both. Evaporative dry eye occurs when the oily tear layer is insufficient, causing tears to evaporate too quickly even when overall tear production seems adequate.
Aqueous deficient dry eye means your eyes do not produce enough of the watery tear layer, often due to problems with the lacrimal glands. Many patients have mixed-type dry eye, and knowing which type is dominant guides us toward the most effective treatments for your specific situation.
Our evaluation often uncovers specific underlying conditions that are driving your symptoms. Meibomian gland dysfunction is the leading cause of evaporative dry eye, while autoimmune conditions are a frequent cause of aqueous deficiency.
- Eyelid inflammation or infection that blocks oil gland openings
- Poor tear quality due to surface inflammation
- Environmental factors such as low humidity, wind, or dry indoor air
- Medications that reduce tear secretion
- Incomplete eyelid closure during sleep or while blinking
In some cases, symptoms are significant even when staining and tear tests appear relatively mild. Our eye doctors may then consider whether nerve-related ocular pain or overlapping conditions such as allergies are contributing to your discomfort.
Treatment and Follow-Up After Your Evaluation
Your evaluation results directly shape your treatment plan. We approach dry eye care in layers, starting with the simplest effective options and building from there based on how your eyes respond.
For many patients, we start with preservative-free artificial tears used several times daily to supplement natural tear volume. Warm compresses applied to your closed eyelids help soften blocked oils in the meibomian glands and improve the quality of your tear film.
We may also recommend gentle eyelid hygiene using specially formulated cleansers to reduce inflammation and keep gland openings clear. Simple environmental changes, such as using a humidifier, taking regular screen breaks, and staying well hydrated, often provide noticeable improvement on their own.
When first-line treatments are not enough, we may prescribe anti-inflammatory eye drops that reduce surface inflammation and help your eyes produce healthier tears. Cyclosporine ophthalmic emulsion, commonly known as Restasis, and lifitegrast, commonly known as Xiidra, are two prescription options we use for this purpose.
Short-term topical steroids may also be considered in appropriate cases to reduce surface inflammation quickly, though these require monitoring for effects on eye pressure and lens clarity over time. Our eye doctors will discuss the right prescription approach based on your specific type and severity of dry eye.
For patients with more advanced or persistent dry eye, additional in-office options can make a meaningful difference. Each option is selected based on your individual evaluation findings and overall health.
- Punctal plugs, which are tiny devices placed in the tear drainage openings to slow tear drainage and keep moisture on your eyes longer, typically considered once surface inflammation is under better control
- Amniotic membrane therapy, which uses processed tissue with natural healing properties to support recovery of the eye surface in more severe cases
Omega-3 fatty acid supplements may also help some patients improve tear quality. Discuss dosing and safety with our team before starting them, especially if you take blood thinners or have any bleeding-related health concerns.
Small daily habits support your treatment results and help manage symptoms between appointments. Remember to blink fully and frequently, especially during screen use, and position your monitor slightly below eye level to reduce the amount of exposed eye surface.
Protect your eyes from wind and dry air by wearing wraparound sunglasses outdoors, and avoid directing air vents or fans toward your face. Giving your eyes regular breaks from contact lenses also helps your eye surface recover and respond better to treatment.
We typically schedule a follow-up appointment four to six weeks after starting new treatments to evaluate your response. If your symptoms improve and surface findings show healing, we may extend the time between visits to every three to six months.
Contact our office promptly if you experience sudden vision loss, severe eye pain that does not improve with lubricating drops, or intense light sensitivity. Thick, yellow, or green discharge may indicate an infection. Contact lens wearers with increasing pain, redness, or discharge should remove their lenses and seek care right away.
Frequently Asked Questions
These answers address common practical questions that go beyond what is covered in the sections above.
Most comprehensive dry eye evaluations take between 30 and 60 minutes, depending on how many tests are needed and whether additional questions come up during your visit. Planning ahead and arriving a few minutes early helps the appointment run smoothly. If you have a complex history or have tried multiple treatments without relief, setting aside a full hour is a good idea.
In most cases, yes. Dry eye evaluations typically do not require dilating drops that significantly affect vision, so most patients drive themselves without difficulty. However, if our eye doctors need to dilate your eyes as part of a broader examination, someone else should drive you home. When you schedule, let our team know if you have concerns about driving afterward so we can give you accurate guidance for your specific visit.
Many medical insurance plans cover dry eye evaluations when symptoms are significant and the visit is medically necessary, but coverage varies widely between plans. Dry eye care is generally billed through medical insurance rather than vision insurance, and some tests may require separate authorization. We recommend calling your insurance company before your appointment to confirm your benefits, copays, and any referral or preauthorization requirements.
Most prescription treatments for dry eye, including Restasis and Xiidra, take several weeks to months to show their full benefit, so early reassurance from our team matters. At your follow-up visit, we compare your symptoms and test results to your baseline to track progress objectively. If one approach is not producing enough improvement, we adjust your plan rather than waiting indefinitely, which is why consistent follow-up appointments are an important part of care.
Dry eye disease is often a chronic condition that requires ongoing management rather than a one-time cure. Many patients do very well with treatment and experience lasting relief, but symptoms can return or worsen with changes in health, season, medications, or environment. Keeping up with follow-up visits and daily self-care habits gives you the best chance of staying comfortable long term. Our eye doctors will work with you to build a sustainable plan that fits your lifestyle.
Our eye doctors review your test results with you during the same appointment and explain what they mean in straightforward terms. You will leave with a clear treatment plan tailored to your specific type and severity of dry eye, along with instructions for starting therapy right away. If any additional tests or consultations are needed, we will discuss the next steps before you leave so you always know what to expect.
Find Dry Eye Relief at NewView Eye Center
If persistent eye discomfort, redness, or blurred vision is affecting your daily life, a dry eye evaluation is an important first step toward real relief. NewView Eye Center brings advanced diagnostic tools and personalized care together to identify the root cause of your symptoms and create a treatment plan built around your needs. We are proud to serve patients throughout Northern Virginia and look forward to helping you see and feel your best.
What our Patients Says
Explore More
Find more information about our doctors, services, and technology that keep your eyes healthy and your vision at its best.