Patients with dry eye disease need to be screened for glaucoma. It is not uncommon for steroids to be used in dry eye disease and is often used in a “pulsed” type fashion. As a result, while the pressure may be measured as “normal” in the office, the intra-ocular pressure could have been elevated during the previous steroid pulse and cause optic nerve damage. Even with mild steroids such as Lotemax. Alrex, or 0.1% FML, pressure elevations can occur especially in patients who are steroid responders. At Fishmanvision, we always include OCT optic nerve analysis as part of our new patient dry eye work-up. At risk patients should have a visual field and the below video snippet is visual field testing as seen from the doctor’s side.