Table of Contents

Schirmer Test
- - Schirmer I Test Procedure
  - References

Schirmer Test

Schirmer I test
- Without Anesthetic
  - Measures the basal tear secretion plus the reflex tearing from the main lacrimal gland
  - Often used when suspecting Sjögren syndrome
- With Anesthetic
  - Measures the basal tear secretion
  - Use in children
Schirmer II test
- nasal mucosa is first irritated with a cotton-tipped applicator

Schirmer I Test Procedure

Insert topic anesthetic drop (omit depending on tearing aspect being tested)
Place a paper wick to draw up tears
1. Before placing the strip ensure there isn't reflex tearing present from the anesthetic
2. Place the bent strip on the eyelid margin on the outer lower 1/3 so it doesn't touch the cornea
Start a timer for 5 minutes
remove the strip and measure the length of the wetting from the bend in the paper

Results

Normal
- ≥10 mm wetting of the paper
Possible Tear Deficiency
- 5-10 mm wetting
Tear deficiency
- <5 mm wetting

References

Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, Gupta PK, Karpecki P, Lazreg S, Pult H, Sullivan BD, Tomlinson A, Tong L, Villani E, Yoon KC, Jones L, Craig JP. TFOS DEWS II Diagnostic Methodology report. Ocul Surf. 2017 Jul;15(3):539-574.
van Bijsterveld 1969. Diagnostic Tests in the Sicca Syndrome