Frequency of dry eye diagnostic test procedures used in various modes of ophthalmic practice

Purpose. There are many suggested dry eye diagnostic test batteries in the literature. However, clinicians use a wide variety of dry eye diagnostic te sts in clinical practice due to a number of factors, including time Constra ints. In addition, there has been no systematic description of the standard of care in diagnosing dry eye in the literature. The purpose of this study is to determine the type and frequency of dry eye diagnostic tests used in various modes of ophthalmic practice across a spectrum of dry eye severity . Methods. A total of 467 patient charts (patients with a previous dry eye diagnosis) were reviewed retrospectively to determine diagnostic test frequ ency. In reviewing patient charts, the following tests were identified as p erformed or not performed: symptom assessment, fluorescein staining, tear b reak-up time (TBUT), Schirmer test, rose bengal staining, and "tear assessm ent" (including quantity and quality of the tear meniscus). Results. Dry ey e diagnostic tests were used in the following frequencies across all modes of practice: symptom assessment (82.8%), fluorescein staining (55.5%), TBUT (40.7%), tear assessment (22.2%), Schirmer test (8.5%), and rose bengal st aining (4.9%). When the clinics are pooled, two test procedures were used w ith the highest frequency (38.9%). The most commonly performed two-test pro cedure combination was a symptom assessment combined with fluorescein stain ing of the cornea (43.7%). Conclusions. Symptom assessment plays a large ro le in the diagnosis of dry eye. The current clinical standard of care for d ry eye diagnosis includes the performance of at least one test procedure in addition to a symptom assessment.