tears: quantitive or quality problem?

[indrep]

wetEyes,
Your docs are sort of right. Lets take the most common tests and see what could be right or wrong.

Schirmer strip test for quantity of tears- If no antisthetic is used you get a lot of tears due to irritation. This would be a false negative. If you use an antistetic you lower the amount of tears you normally make so you get a false positive.

TBUT(Tear BreakUp Time)- This is generally ised to see how quickly your tears evaporate. Theoretically this gives an idea of lipid layer thickness. What if you have a low aqueous flow and a steep cornea? You would have low TBUT and theoretically a diagnosis of inadequate lipid layer, a false positive.

The doctor can do a dye test and see the dead epithelial cells (the outer cells of your cornea) and know that your mucin layer is thin. But is the mucin layer thin because of low goblet cells and is therefore the cause of the disease or is the mucin layer thin due goblet cell loss due to inflammation that was caused by anotehr reason, low aqueous or high evaporation.

What you really need is a doc who will listen to your symptons and find a treatment plan that helps you. Good luck. This is a journey.

[wetEyes]

Thank you indrep for your elaborate and knowledgable reply!

[sanna]

Schirmer strip test for quantity of tears- If no antisthetic is used you get a lot of tears due to irritation. This would be a false negative. If you use an antistetic you lower the amount of tears you normally make so you get a false positive.

TBUT(Tear BreakUp Time)- This is generally ised to see how quickly your tears evaporate. Theoretically this gives an idea of lipid layer thickness. What if you have a low aqueous flow and a steep cornea? You would have low TBUT and theoretically a diagnosis of inadequate lipid layer, a false positive.

.

Is that so, if you use antisthetic you lower the amount of tears when you do the test? I did the test and the doctor said i had dry eye, but i do not feel dry at all! I only use drops at night. The doctor used antisthetic, now i know the test was not right.

About the tbut, can a person have low aqueous flow and great tbut?

[indrep]

sanna,
It is possible for you to have low aqueous flow and a good TBUT. This could be caused by a heavy secretion of lipids(they regulate evaporation). Lipids in and of themselves in large quantities can be toxic to the ocular surface so it is unlikely this could go on for long period of time.

[sanna]

sanna,
It is possible for you to have low aqueous flow and a good TBUT. This could be caused by a heavy secretion of lipids(they regulate evaporation). Lipids in and of themselves in large quantities can be toxic to the ocular surface so it is unlikely this could go on for long period of time.

Thanks,
I was thinking that it has to be like that, but no doctor have ever told me.