We are changing our point of view on how to approach the dry eye, from diagnostic tests to therapeutic strategies. Up to now, the analysis of the tear, its quantity and quality, was performed in a very mechanical way and very little practice. Tests were performed with a high rate of error, as Schirmmer test, strips of paper that attempt to measure the amount of tears generated in the lachrymal gland, a complex, tedious and largely ineffective test, (performed in the same way that proposed Otto Schirmmer in 1903).
We currently propose to evaluate the anatomical structures of the ocular surface as well as the eyelids and then study the tear and the tear film, not in a static but a dynamic way. We are interested in the balance between the tear that is generated in the lachrymal glands and the dynamics of evacuation by the tear ducts. The dynamics of the tear film formation in each blink is also important. Tear film stay a few seconds humidifying the eye and preventing it to blink constantly.
Let’s look in more detail how we can analyze the main factors for dry eye diagnosis and subsequent treatment: