The Comprehensive Dry Eye Assessment

A comprehensive first assessment typically takes between 45 minutes and an hour. That includes a structured history, all of the diagnostic testing, and a detailed discussion of findings and your treatment plan at the end. Follow-up visits are shorter — usually 30 to 45 minutes — since the baseline has already been established and the focus is on treatment delivery, progress monitoring, or targeted retesting.

Bring a list of every eye drop, ointment, and oral supplement you’re currently using or have used in the past six months — prescription and over-the-counter. A list of any other medications you take and any diagnosed medical conditions. If you wear contact lenses, please bring your prescription and stop lens wear at least 24 hours before your visit so we can assess your natural ocular surface. Bring your OHIP card and, if applicable, your extended health insurance card. Any prior testing, imaging, or consult letters from a previous eye care provider are also useful — it saves repeating work.

The physician portion of your assessment is typically OHIP-covered when medically indicated — which applies to almost all symptomatic patients being worked up for dry eye. Some specific diagnostic tests (such as meibography or tear osmolarity) are not covered by OHIP and are billed as an out-of-pocket or insurance-claimable service. We’re transparent about costs from the start, and you’ll be told which parts of your visit carry a fee before any testing begins. There are no hidden charges at your initial consultation.

No — you can self-refer directly to UDEI for a dry eye assessment. That said, most patients arrive having been referred by an optometrist or family physician, and we welcome referrals through any of the usual channels. If you’re coming via optometric referral, bring any prior notes, photographs, or test results your referring clinician has already gathered. It accelerates your assessment and avoids repeating tests unnecessarily.

In most cases, no — we want to see your ocular surface in the state it’s currently in on treatment. The one exception is that we’d prefer you skip any drops in the two hours immediately before your appointment so we can get clean diagnostic measurements. If you’re currently on steroid drops, cyclosporine, lifitegrast, or other prescription dry-eye medications, keep using them as directed and simply let us know. If you wear contact lenses, stop lens wear at least 24 hours before your visit so we can evaluate your natural ocular surface rather than the lens-affected one.

For many patients, yes. Some first-visit treatments — in-office meibomian gland expression, lid hygiene coaching, prescription drops, a first UltraView DEL™ session — can be started on the day of the assessment if scheduling allows and the clinical findings support it. More specialised treatments like hemoderivative production or a full IPL course are scheduled for a follow-up appointment. Whether or not you leave with treatment already started, you’ll leave with a clear written plan and your next appointment on the calendar.

Being told you have dry eye and knowing which kind you have are two different things. A general “you have dry eye” doesn’t specify whether you’re aqueous-deficient, evaporative, mixed, or something else — and that distinction changes the entire treatment plan. Most patients who come to UDEI with an existing diagnosis leave with a more precise one, a clearer picture of severity, and a plan that matches the actual pathology rather than a generic dry eye protocol. Often they also leave having discovered a contributing condition — blepharitis, Demodex, preservative toxicity — that had been overlooked.

Dry eye is one of the most over-diagnosed and under-characterised conditions in eye care, precisely because the visible signs often lag behind the underlying pathology. A patient with moderate disease can have an eye that looks nearly normal to the naked eye; another patient can have an alarming-looking surface with mild symptoms. Objective measurements — osmolarity, meibography, tear break-up time, staining patterns — give us a picture of what’s actually happening on the surface, not just what we can see at a glance. That precision is what allows treatments to work the first time instead of becoming a cycle of trial and error.

Yes. Paediatric and adolescent dry eye is less common than adult dry eye but very much real — particularly with high screen use, heavy contact lens wear, certain systemic conditions, and after ocular or refractive surgery. The assessment is adapted to age and comfort level but the diagnostic questions are the same. If you’re unsure whether your child is a good candidate for assessment, please contact our front desk and we’ll advise before booking.

Fax referrals to 416-292-0331, or contact our referral desk at 416-292-0334 or info@udei.ca. A consult letter with findings and treatment plan is returned to you within one week of the patient’s visit. To formally join the UVG Professional Relations network — for streamlined referral pathways, co-management updates, and CE opportunities — sign up at uptowneye.ca/referring-doctors.