Op-Med is a collection of original articles contributed by Doximity members.
Speaker: Anat Galor, MD, University of Miami
Session: Point-of-Care Testing for Dry Eyes: Tears of Joy, or Tears from the Expense?
Our expectation is we want one test that tells us yes or no dry eyes. But our reality is, that dry eyes is an umbrella. There are different subtypes of dry eye and what point of care tests are more likely to do is tell us what are some features going on and hopefully that will be able to help individualize our therapies.
So, what some of our point of care tests can do now is tell us whether there is ocular surface inflammation, there is a test called InflammaDry that does that. We can look at ocular surface stability, so we can measure osmolarity. There is a test that does that, it is made by TearLab. There are tests that can look at different parts of the tear film, so for example the lipid layer, LipiView is a test that does that. And ones that can image the meibomian glands and we have two instruments LipiView and Keratograph that can do that. And then we have some tests that can try to diagnose diseases that are associated with dry eye like Sjogren’s earlier and that’s called a Sjo test and what I went through yesterday, is I explained how most of these tests are financially feasible, they are not going to make you a millionaire; but they can be incorporated into clinical practice and they give useful information of different components of dry eye, but none of these is a panacea and will not tell you yes or no dry eye.
The data we don’t have yet is how these tests are going to influence therapy. Since right now, we don’t have the data to say well you are MMP9 positive, this is what you should be treated with. And hopefully that is to come. But the take home point was that it’s more tears of joy than tears of the expense but there are limitations to all these tests and you could be a great clinician without any of them. But if you have a large population of patients with dry eye; you should look at what’s available and see what you should integrate into your practice.