Dry eye examinations

How is a dry eye examination different from a regular eye examination?

When patients come to us for dry eye disease, there are special things we do that are not part of a regular eye exam.

In dry eye patients, one thing we play close attention to is the meibomian glands.Meibomian glands are found at the rim of the eye lids and they are responsible for the supply of meibum, an oily substance that prevents evaporation of the tear film. When the meibomian glands are not working properly they do no secrete enough meibum, causing tears to evaporate too quickly, which results in dry eyes.

For these reasons, an evaluation of the meibomian glands is a key part of the dry eye examination. We look closely at the meibomian glands and we try to make them secrete the oily meibum that they are made for. Meibum is an essential component of a healthy tear film. This process is called gland expression and it is usually done with Q-tips, the doctor's finger tips or specially designed squeezers.

We typically grade the quality and quantity of the the secretions and look to see how easy it is to apply pressure to the glands to make the secretions visible at the eye lid margin.

An assessment of the meibomian glands gives doctors a good idea of whether a patient has an evaporative dry eye or an aqueous-deficient dry eye, or a combination of both.  Knowing the latter points the way to selecting a proper treatment for the patient.

Other Components of a Comprehensive Eye Exam

If your dry eye complaint is part of your regular eye comprehensive eye exam, we will also evaluate the following.

Glasses, contacts and laser surgery

Dr. Randhawa checks for astigmatism, nearsightedness and farsightedness and will prescribe glasses, contact lenses, orthokeratology or refers you to a surgeon for laser eye surgery (depending on what is best for the patient) to correct your near or farsightedness.

Cataracts

This is the leading cause of vision loss in adults. If caught early and properly treated, cataracts can be treated with 100% success.

Glaucoma

This is the second leading cause of blindness. The progress of permanent vision loss from glaucoma can be stopped only if caught early in an eye health exam. Glaucoma sneaks up on many patients who don’t know that they are suffering permanent vision loss. Remember, vision lost to glaucoma cannot be restored. It is critically important to have your eyes checked regularly to stop the disease.  Learn more about glaucoma here.

Macular degeneration

This is the leading cause of blindness world-wide and is a common cause of impaired reading or detailed vision and can eventually cause blindness. If caught early in an eye health examination, the progress of the disease can be slowed.

Presbyopia

This is en inevitable condition in which the ability to focus on close objects decreases over time. There is a wide range of treatment options, including bifocals and special contact lenses.

Retinal detachments

Retinal detachments can cause permanent vision loss if not treated with surgery immediately. Dr. Randhawa and the Vision Source Vancouver team is able to diagnose retinal detachments in an eye health exam and if she finds one, she makes arrangements with a surgeon to have the surgery completed immediately to minimize the risk of permanent vision loss.

Eye movement disorders

These problems include eye muscle weakness and other conditions affecting the proper functioning of the eye that could lead to difficulties in learning, seeing clearly, sports and others problems. Vision Source Vancouver optometrists, lead by Dr. Randhawa use Vision Therapy to treat eye motor deficiencies. These disorders include convergence insufficiency, general binocular dysfunctions, strabismus, amblyopia and more.

Tumors, cancers, hypertension, heart disease, diabetes and many other systemic diseases

Eye Exams are often the first to detect chronic diseases.

A 2011 study confirms that eye exams by an optometrist or ophthalmologist are often the first to detect chronic diseases like diabetes and hypertension. The researchers found that eye doctors detected signs of certain chronic conditions before any other health care provider recorded the condition—65 percent of the time for high cholesterol, 20 percent of the time for diabetes, and 30 percent of the time for hypertension.

The study demonstrate that in addition to updating yoru lens perspecription and and keeping your vision clear, eye exams are important for your overall health. Annual eye exams are excellent atdetecting signs of chronic diseases at the earliest stages because eye doctors have the only unobstructed, non-invasive view of the body's blood vessels - which they observe through the eye in an eye examination.