Why inflammation is tested
Inflammation is what turns occasional dryness into chronic dry eye disease, and it does not always show at the slit lamp. Stressed surface cells release MMP-9, which breaks down the surface's own structure and perpetuates the cycle. Its level in the tears is elevated in a large proportion of dry eye patients, and those patients respond to anti-inflammatory drops. Those drops take weeks to act and are used long term, so knowing in advance who will benefit avoids months of the wrong treatment.
The test
A small sampling fleece is dabbed gently along the inside of the lower eyelid to collect tears, then snapped into a test cassette that is dipped in a buffer solution. Within ten minutes a line appears in the result window if MMP-9 is above the threshold, in the same format as a rapid pregnancy test. Both eyes are usually tested. No anesthetic is needed.
How the result changes treatment
Positive: an anti-inflammatory drop (cyclosporine or lifitegrast) is started for the long term, sometimes with a short steroid course to settle the surface quickly, alongside treatment of the underlying gland or tear deficiency. Negative: treatment concentrates on the meibomian glands, tear retention and lubrication, and anti-inflammatories are held in reserve. The test is repeated at follow-up to confirm that inflammation has resolved before drops are reduced.
Is this right for your eyes?
Nothing on this page is a diagnosis. Whether this is the right choice for you is decided by a full examination at one of our 4 offices: Pasadena, Huntington Beach, Woodland Hills and Beverly Hills.
About this content: This page was written with the assistance of AI tools and reviewed for medical accuracy by Dr. Bavand Youssefzadeh, DO. It is general information, not medical advice, and does not replace an eye examination. Individual results vary. Read our medical disclaimer.
