Healthcare providers diagnose dry eye through your medical history, an eye exam and testing.

Medical history

Your provider may ask you to fill out a questionnaire to learn about your symptoms and medical history. You should be prepared to provide lots of information, including:

  • Eye-related symptoms and how long you’ve had them.
  • Environmental factors that make your symptoms worse.
  • Other symptoms, including dry mouth, cavities, mouth ulcers, fatigue and joint pain.
  • Allergies.
  • History of eye diseases.
  • History of other medical conditions, including allergies and chronic viral infections.
  • History of surgeries.
  • Whether you smoke or are around second-hand smoke.
  • How often you wash your eyelids, and what products you use.
  • History of trauma to your eye area.

Eye exam

Your provider will give you a thorough eye exam to check the health of your eyes and determine what’s causing your symptoms. During your exam, your provider:

  • Looks for signs of dry eye.
  • Looks for other possible causes of your symptoms, besides dry eye disease.
  • Checks the health of your tear film (the three layers of tears that cover your cornea).
  • Performs testing.

Tests that diagnose dry eye

There’s no single test that diagnoses dry eye. Rather, providers may use many tests, including:

  • Slit lamp exam: This test checks the amount of tears your eyes produce. The provider shines a light into each of your eyes and uses a microscope to examine your eyes and eyelids.
  • Schirmer’s test: This is another way to check your tear production. The provider places a tiny piece of paper along the edge of your eyelid and leaves it there for several minutes. Your eye produces tears in response, and your provider then measures those tears by looking at how much of the paper they cover.
  • Tear breakup time (TBUT) test: This test checks how quickly your tears evaporate. The provider puts dye into your eye and uses a microscope to see how long your tear film remains stable (doesn’t break up). They measure the amount of time between your last blink and when the first dry area shows up on your cornea. A time of fewer than 10 seconds can signal dry eye disease.

Healthcare providers also may order other tests, such as antibody tests, to check for underlying conditions that could be causing your dry eye.