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Dry eye Assessment Questionnaire

Questions Your Doctor May Ask - and Why!

During a consultation, your doctor will use various techniques to assess the symptom: Dry eye. These will include a physical examination and possibly diagnostic tests. (Note: A physical exam is always done, diagnostic tests may or may not be performed depending on the suspected condition) Your doctor will ask several questions when assessing your condition. It is important to openly share any pertinent information to help your doctor make an accurate diagnosis.

It is also very important to bring an up-to-date list of all of your all medical conditions, medications including dosages, and names of numbers of any specialist you see.

Create your printable checklist by answering questions that your doctor may ask below:

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  1. How long have you had problems with dry eyes?

    Why: to establish if acute or chronic.

  2. Is it unilateral or bilateral?

    Why: Unilateral dry eye may suggest foreign body, facial nerve (7th nerve) palsy, Bell's palsy or Herpes zoster oticus.

  3. What is the age of the person with dry eyes?

    Why: elderly people often complain of a chronic gritty sensation due to reduced tear secretion with age.

  4. Are there simple reasons for the dry eyes?

    Why: e.g. wearing contact lenses, excessive reading, excessive computer usage, windy conditions, dry weather conditions, air travel (because the air in planes is dry), air-conditioning (air conditioners remove moisture from the air) and home heating.

  5. Is there a chance there may be something in your eye, or do you feel like there is something in your eye?

    Why: may suggest presence of foreign body.

  6. Fluid intake?

    Why: may suggest inadequate intake of fluid and dehydration as cause of dry eyes e.g. poor fluid intake due to illness, anorexia, malnutrition or neglect.

  7. Have you been treated with radiation therapy?

    Why: may cause dry eyes.

  8. Past medical history?

    Why: e.g. Rheumatoid arthritis; systemic lupus erythematosus; primary biliary cirrhosis; diabetes; Vitamin A deficiency and dry eyes may occur in people with liver disease, intestinal sprue, after intestinal bypass and if receiving total parenteral nutrition.

  9. Medication?

    Why: e.g. antihistamines, decongestants, antidepressants, beta blockers, oral contraceptive medications and isotretinoin for severe acne may cause a dry eyes.

  10. Dietary history?

    Why: e.g. dietary deficiency of Vitamin A often due to failure to incorporate green leafy vegetables into the diet usually exclusively in developing countries may cause night blindness and dry eyes.

  11. Illicit drug use?

    Why: e.g. marijuana may cause dry eyes.

  12. Symptoms of Primary Sjogren's syndrome?

    Why: e.g. dry eyes, dryness of the mouth, skin or vagina. This syndrome may be associated with many systemic conditions such as Raynaud's phenomenon, difficulty in swallowing (as seen in systemic sclerosis), painful joints (like that seen with systemic lupus erythematosus), thyroid disease, myasthenia gravis, primary biliary cirrhosis, chronic active hepatitis, renal diabetes insipidus, renal tubular acidosis and vasculitis.

  13. Symptoms of Rheumatoid arthritis?

    Why: e.g. joint pain, swelling, deformity and morning stiffness. It may also cause a number of systemic symptoms including carpal tunnel syndrome, anemia and enlarged spleen. 15% of people with Rheumatoid arthritis have a secondary Sjogren's syndrome which comprises dry eyes and dry mouth.

  14. Menopausal symptoms?

    Why: e.g. palpitations, hot flushes, night sweats, lightheadedness, dry skin, dry vagina, mood change. - may also experience dry eyes which is thought to be due to estrogen withdrawal.

  15. Symptoms of Bell's palsy?

    Why: e.g. marked weakness on one side of the face, mouth sags, drooling from the affected side of mouth, loss of taste on front of tongue, eye may water, pain behind the ear, incomplete closure of the eye and resultant dry eye.

  16. Symptoms of Grave's disease

    Why: e.g. preference for cooler weather, increased appetite, heart palpitations, increased sweating, nervousness, irritability, diarrhea, lack of menstrual periods and proptosis (forward displacement of the eyeball) with resultant dry eyes.

  17. Symptoms of primary biliary cirrhosis?

    Why: e.g. itchy skin, jaundiced (yellowing) skin.

  18. Symptoms of dehydration ?

    Why: e.g. thirst, postural dizziness, fainting and reduced urine output - may cause dry eyes.

  19. Symptoms that may cause dehydration?

    Why: e.g. vomiting, diarrhea, fever, excessive urination, extensive exfoliation of skin.

  20. Facial rash?

    Why: may suggest Lupus erythematosus (which may be associated with Sjogren's syndrome).

  21. Symptoms of Raynaud's phenomenon?

    Why: e.g. sequential discoloration of the digits from pallor to blueness to redness upon exposure to cold. When fingers become red they are painful. Raynaud's phenomenon may be associated with Sjogren's syndrome.

  22. Problems with the eyelids?

    Why: may suggest blepharitis as cause of the eye dryness.

Conditions listing medical symptoms: Dry eye:

The following list of conditions have 'Dry eye' or similar listed as a symptom in our database. This computer-generated list may be inaccurate or incomplete. Always seek prompt professional medical advice about the cause of any symptom.

Select from the following alphabetical view of conditions which include a symptom of Dry eye or choose View All.

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Conditions listing medical complications: Dry eye:

The following list of medical conditions have 'Dry eye' or similar listed as a medical complication in our database.


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