**6.5 Inflamation test**

INFLAMMADRY: Inflamma Dry is a rapid, in-office test that detects elevated levels of MMP-9, an inflammatory marker which is consistently elevated in the tears of patients with DED [39].

### **6.6 No contact evaluation**

There are new devices at our disposal, which can evaluate and perform an adequate evaluation of the ocular surface. We explain two of them (No commercial interest). With these reports, the physician can explain an show the different characteristics altered in the test. This unique feature can improve the adherence to treatment.

	- NIBUT (No invasive brake up time).
	- Lacrimal meniscus height.
	- LIPID LAYER INTERFEROMETRY Measures lipid layer thickness and accurately diagnoses and monitors lipid-deficient tear.
	- MEIBOGRAPHY: Specialized imaging study developed exclusively for the purpose of directly visualizing the morphology of meibomian gland, they play a significant role in tear production by contributing lipids to the superficial tear film and hence dysfunction of the meibomian glands results EDE.
	- NIBUT.
	- Lacrimal meniscus height.
	- LIPID LAYER INTERFEROMETRY Measures lipid layer thickness and accurately diagnoses and monitors lipid-deficient.
	- MEIBOGRAPHY: Specialized imaging study developed exclusively for the purpose of directly visualizing the morphology of meibomian gland, they play a significant role in tear production by contributing lipids to the superficial tear film and hence dysfunction of the meibomian glands results EDE.

Management proposal

Once the glaucoma is diagnosed or we evaluate our patients in control, and recognize subjective or objective symptoms or signs, an escalated treatment is proposed. Our goal is **provide an adequate treatment, looking for no glaucoma progression with the minimal or none ocular discomfort.**
