Is Treatment Working? Having That Conversation With Your Doctor

How Doctors Diagnose Dry Eye

Your eye doctor will ask you questions like these about your dry eye symptoms and general health: 

• Do you have other symptoms, like dry mouth, thirst, mouth sores, tiredness, or joint pain?
• Have you had any eye diseases in the past?
• Do you have allergies?
• What eye surgeries, if any, have you had?
• Do you smoke? Are you around secondhand smoke?
• Have you had any injuries to your eyes?

Your eye doctor may also perform tests to help them figure out whether dry eye is to blame for your symptoms. Some of those tests include:

Dilated eye test. Your eye doctor will first give you drops to dilate (widen) your pupils. Then they'll check for signs of dry eye.

Shirmer's test. This test can show whether your eyes are making enough tears. First you'll get drops to numb your eyes. Then the doctor will put a small piece of paper on the edge of your eyelids. You'll keep your eyes closed for 5 minutes while the paper absorbs your tears. Then your doctor will measure how much of the paper is wet.

Common Causes

There are a lot of causes older people have dry eyes, including hormonal changes in women. These are some possible reasons why you could be experiencing dry eye symptoms:

• You have eyelid swelling called blepharitis.
• You have a medical condition like diabetes, thyroid disease, rheumatoid arthritis, Parkinson's disease, or Sjӧgren's syndrome that causes dry eye.
• You wear contact lenses for long periods of time.
• You spend a lot of time in front of a computer, tablet, or smartphone screen. 
• You live in a dry or windy climate.
• You take medicines such as beta-blockers or diuretics to lower blood pressure, cold and allergy medicines like antihistamines, anti-anxiety drugs, sedatives, glaucoma eye drops, or heartburn medicines.
• You've had LASIK, cataract, or other eye surgery.

Treatments and Results

You have a lot of options when it comes to dry eye disease treatments. You might start with over-the-counter artificial tears or ointments for mild symptoms and see if they improve. Or visit your eye doctor for prescription medicines to manage moderate to severe symptoms.

Discussing Treatment Plans With Your Doctor

Once your doctor has learned the cause of your dry eye, you can work together on a treatment plan. That plan should be customized to you based on your disease severity and symptoms. If you have mild to moderate dry eye symptoms, your doctor might suggest you start with over-the-counter artificial tears. For more severe symptoms, a prescription eye drop may be a better option.

Ask your doctor to go over all of your treatment options. Find out how each one works and what side effects it might cause. 

Questions to Ask Your Doctor

You have a limited amount of time to spend with your eye doctor. Preparing for your appointment in advance will help you make the most of the time you do have. It helps to bring a list of your symptoms, which you can track at home in a diary or journal. Don't include only eye symptoms. Other symptoms, like joint pain or excess thirst, could signal that a medical condition is causing your dry eye.

Also bring a list of questions to ask your doctor, a list of all the medicines and supplements you take, and a notepad or tablet to write down your doctor's answers.  

Here are some questions for your doctor to get you started:

• What do you think caused my dry eye?
• What tests will you do to diagnose the problem?
• Do I need treatment?
• Could treating an underlying health condition help?
• What treatment options are available?
• How do they work?
• What are the possible side effects and complications of the treatment you've recommended?
• Are any new medicines available to treat dry eye?
• What outcome do you expect from the treatment you're recommending? What kinds of results can I expect?
• What websites can I go to for more information about dry eye?
• When do I need to see you again for a follow-up visit?
• How can I reach you if I have a problem between appointments?

Questions Your Doctor Will Ask You

To get the right diagnosis, your doctor will also need some information from you. Prepare to answer questions like these:

• When did your symptoms start?
• How often do you have symptoms? 
• Are your eyes dry all the time, or do symptoms come and go? 
• How does dry eye affect your daily activities?
• When do you notice dry eye most?
• Do other members of your family have dry eye or other eye conditions?
• What medicines do you take?
• Have you had eye surgery?
• Have you tried any dry eye treatments? How well did they work?

Your dry eye treatment will be most likely to help if you take it the way your doctor prescribed. If you have side effects or problems taking your medicine, let your doctor know. They may be able to switch you to something that's easier for you to tolerate.

What to Expect

There's no cure for dry eye. It's a chronic condition. But over-the-counter and prescription medicines, procedures, and lifestyle changes can relieve the dryness and other symptoms. 

It can take some time to find the treatment that works best for you. Some prescription medicines take a few months to start working. Be patient and stick with your treatment plan. But if months pass and you still haven't gotten any relief from dry eye disease symptoms, go back to your eye doctor to discuss other options.