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DP: Eyecare Update: Tear Sample Testing?

Dry Eye Senior Woman 640×350

Q: I was telling my eye doctor about my fuzzy vision with my computer and he recommended some sort of “tear testing”. This seems pretty far fetched to me, is this useful or valid?

A: This will perhaps surprise you, but the number one symptom of dry eye disease is fuzzy or blurry vision with reading! I think most people would assume that dry eyes feel “dry"... and they can, but for most the earlier clue is this vision change. And to explain that further, this fuzziness tends to come and go, and generally improves when you blink or rub your eyes. Those actions cause more tear production and re-moistens your eyes.

The cornea is that clear layer on the very front center of our eyes. This highly innervated tissue is the primary “refracting” surface of the eye...meaning it focuses our vision. When that clear layer gets dry the images we see become fuzzy or blurry too. In my experience, this is most often noticed while looking at a digital device. Whether it’s your tablet, cell phone, laptop or desktop we all tend to blink less often doing such visual tasks. Our normal blink rate of about every 5 seconds slows to about 20 seconds…..we sort of “stare” at our screens. This infrequent blinking can cause your eye surface to become dry.

Tear sample testing is fairly new, but very useful. We take a tiny sample of your tear fluid and use an analytical instrument to evaluate certain components of your tears. Most commonly we measure the “osmolarity” or saltiness of your tears, and check for chemical mediators of inflammation. These results can tell us the cause of your dry eyes and direct us to the most effective treatment. This could tell us to prescribe an eye medication, or treat damaged eyelid oil glands, or to use lacrimal plugs, for instance.

Frankly this is a very common problem, and more common with each birthday. We see this with younger patients these days, often in their 30’s instead of 50’s as in the past. To be complete, many patients do have a mild vision problem focusing for near vision and need glasses specifically for computer use. Lastly, people ask us about “blue light” these days, but I am not convinced it is a near the danger that Ultraviolet light is, and certainly in not a cause of blurriness.

It seems to me, your doctor is on the right track and appears to be more up to date than many. Finding the actual cause can take some time and a few painless tests, but should provide a far better solution for long lasting comfort and clarity.