Our goal at Center for Eye Comfort is to understand why you are experiencing discomfort in your eyes and to determine the cause of your disease. At your dry eye consultation and assessment we begin with our state-of-the-art technology to help Seattle Dry Eye Specialist Dr. Habibi assess your individual concerns, diagnose the cause of your symptoms, and subsequently treat dry eye disease.
Tear Osmolarity Testing
Do you have salty tears? Salty tears are a hallmark sign of dry eye disease. By testing the osmotic concentration of the tears, we can determine just how dry they are. This test tells us how dry your eyes are during your appointment and allows Dr. Habibi to monitor the success of your treatment.
Tear Inflammation Testing
How have your eyes felt over the past couple of months? We want to know and can see evidence of symptoms before they worsen through testing for inflammation. Inflammatory markers are released when the body is in a state of inflammation. This test identifies the inflammatory marker, MMP9, that is consistently elevated in the tears of patients with dry eye disease. With proper treatment, test results will improve over the course of a few weeks or months.
Lipid Layer Analysis via LipiView
How thick is the oil on your eyes? The lipid (fatty oil) layer of the tear film is the outermost layer of the tear film. Like a warm outer coat keeps in warmth, the lipid layer keeps in moisture. It prevents the water layer of your tears from quickly evaporating. We want to know how thick the oil layer is and how well your body is expressing it across the eye. The LipiView uses interferometry to accurately measure lipid layer thickness so that Dr. Habibi can see if we should take a closer look at the processes that make it.
Meibomian Gland Structural Analysis via LipiView
Do you still have your glands? The meibomian glands make and express the lipid layer of the tears. We want to evaluate the meibomian glands to determine if they have suffered any structural damage or “dropped out” from disuse. Damage to the glands is permanent and progressive in nature. Depending on the severity, Dr. Habibi will advise appropriate treatment options based on your individual analysis.
Meibomian Gland Functional Analysis
How well are your Meibomian glands working? Although structural changes may be observed, Dr. Habibi will further evaluate the amount of oil being secreted from the glands. Naturally, oil is released by the glands during a “complete blink,” or full contact between the eyelids. This blinking action causes muscles around the glands to activate and squeeze the oil from the glands. To properly assess the function of the glands, the amount of pressure exerted from blinking must be applied to the glands. If oil comes out, then the gland is functioning properly; if nothing comes out, the gland is not functioning properly.
Blink Dynamics Analysis via LipiView
Are you blinking correctly? Are you often on the computer or your cellphone? Complete blinks are crucial to providing a well lubricated, comfortable eye surface. The meibomian glands release the lipid layer of the tears with each “complete blink,” or full contact between the eyelids. This action causes muscles around the glands to activate and squeeze the oil from the glands. Increased computer work decreases frequency and effectiveness of blinking. This has led to a large proportion of poor or “partial” blinkers who we can identify with the Blink Dynamics analysis of our LipiView machine.
Evaluating Tear Film
Do you have dry spots on your eyes? The tear film coats the surface of the eye to provide protection, comfort, and maintenance to the tissue. Blinking the eye when its surface is dry is like using wiper blades on a dry windshield. To combat this, every time you blink your tears are redistributed across the surface of the eye. By applying dyes to the tear film, we can analyze how well they are coating the surface, how stable they are between blinking, and whether there is a specific pattern of tear decomposition or dry spots. These clues help Dr. Habibi to better understand the source of your eye discomfort and more effectively treat it.
Ocular Surface Staining
Is something else causing your dry eye? Using dyes, Dr. Habibi can analyze damaged tissue on the front of the eye that is the result of chronic irritation, infection, or other diseases. If something else is causing your dry eye, we want to find out what it is so that you can start the appropriate treatment and finally find some comfort and relief.
We utilize two different questionnaires at our office: the Standard Patient Evaluation of Eye Dryness (SPEED) Survey and the Ocular Surface Disease Index (OSDI) questionnaire. You will fill these out prior to your initial consultation and again during the course of your treatment. These allow us to monitor your progress.