Dry Eye Syndrome (Keratoconjunctivitis Sicca): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

• General physical examination – including blood pressure, pulse, body weight, height; furthermore:
  • Inspection (viewing).
    • Skin and mucous membranes
    • Eyes [mucous secretion, tired eyes, swollen eyelids, red eyes], furthermore inspection of eyelids:
      • Eyelid blink frequency (during speech (15 ± 13 blinks/minute) and reading (5 ± 4 blinks/minute); typically, patients with dry eye have reduced intervals between blinks from approximately 6 seconds to 2.6 seconds)
      • Eyelid position and closure:
        • Eyelid malposition? (e.g., ectropion/outward tilt of eyelid, usually lower eyelid, entropion/inward tilt of lower eyelid, usually lower eyelid).
        • Eyelid closure insufficiency? (eg, facial nerve palsy)
      • Lid margin:inflammation or dysfunction of the meibomian glands.
• Ophthalmic examination: slit lamp microscopic examination shows:
  • Skin redness and damage to the ocular surface with punctate epithelial defects (keratitis punctata superficialis); late stage or severe course: Connective tissue hardening and corneal complications.
  • Lacrimal lake (lacrimal meniscus) at the lower lid margin reduced.
  • If necessary, additional signs of meibomian gland dysfunction (thickened eyelid margins and telangiectasia / macroscopically visible dilatation of superficially located smallest blood vessels).

  For further examinations, see medical device diagnostics.

• Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.