The Schirmer Tear Test: What is It?
The Schirmer tear test is a simple, quick, and non-invasive diagnostic test used to evaluate the production of tears in the eyes. It is used to diagnose dry eye syndrome, a common condition in which there is not enough moisture in the eyes, leading to discomfort and an increased risk of eye infections and other problems.
How the Test is Performed?
The Schirmer tear test is performed by an ophthalmologist or optometrist. The procedure for the Schirmer tear test is straightforward and involves the following steps:
1.) Preparation: Before the test, the patient should remove any contact lenses and avoid using eye drops for at least 24 hours. The test should be performed in a quiet and well-lit room.
2.) Placement of the Test Strips: The test strips used in the Schirmer tear test are small strips of filter paper that are about 5mm wide and 35mm long. The strips are folded at the designated line and then inserted under the lower eyelid, with the shorter end pointing towards the nose. The strips should be placed in both eyes at the same time.
3.) Waiting Period: After the strips have been inserted, the patient is instructed to close their eyes and wait for five minutes. During this time, the strips absorb tears that are produced by the eye.
4.) Removal of the Test Strips: After five minutes have elapsed, the strips are removed from the patient's eyes. The amount of moisture on the strips is then measured to determine the amount of tears that were produced.
5.) Reading the Results: The test strips are examined and the length of the wet portion of the strip is measured in millimeters. A measurement of less than 10mm is indicative of dry eye syndrome. Measurements between 10mm and 15mm may indicate borderline dry eye, while measurements over 15mm are considered normal.
The Schirmer tear test is a simple and safe procedure that can be performed by a healthcare professional in an office setting. It is non-invasive and typically does not cause any discomfort to the patient. However, patients with sensitive eyes or eye infections may experience mild discomfort during the test.
Interpretation of Results
The results of the Schirmer tear test are interpreted based on the length of the wet portion of the strip and are used to diagnose and manage dry eye syndrome.
Interpretation of Schirmer Tear Test Results:
Normal Results
A measurement of over 15mm of wetting on the Schirmer tear test is considered normal. This indicates that the eyes are producing an adequate amount of tears to keep the eyes moist and comfortable. Normal results do not rule out other causes of dry eye, and further testing may be needed.
Borderline Results
A measurement between 10mm and 15mm of wetting on the Schirmer tear test is considered borderline. This suggests that the eyes may not be producing enough tears, and the patient may experience some symptoms of dry eye. Additional tests may be needed to confirm the diagnosis.
Abnormal Results
A measurement of less than 10mm of wetting on the Schirmer tear test is considered abnormal. This indicates that the eyes are not producing enough tears, and the patient may have dry eye syndrome. Further testing may be needed to determine the underlying cause of the condition.
Interpreting the results of the Schirmer tear test is only one part of the diagnostic process for dry eye syndrome. A comprehensive evaluation of the patient's symptoms, medical history, and other diagnostic tests may be needed to confirm the diagnosis and develop an effective treatment plan.
It is important to note that the Schirmer tear test is not always accurate, and false positive or negative results may occur. Additionally, the test may not be helpful in cases of evaporative dry eye, a condition in which the tears evaporate too quickly due to an issue with the oily layer of the tear film.
Other Factors to Consider
It is important to note that the Schirmer tear test only measures the amount of tears produced and not their quality or composition. Additionally, some factors, such as certain medications and medical conditions, can affect the results of the test and should be considered by the healthcare provider when interpreting the results.
Treatment for Dry Eye Syndrome
Treatment for dry eye syndrome will depend on the underlying cause and severity of the condition. Common treatments for dry eye syndrome include using artificial tears, using warm compresses to stimulate tear production, using a humidifier to increase moisture in the air, and avoiding environmental factors that can contribute to dry eyes, such as wind and low humidity. In more severe cases, prescription medications or procedures may be necessary to improve tear production and manage symptoms.
Summary
Schirmer tear test is a useful tool in the diagnosis of dry eye syndrome and can help healthcare providers determine the best course of treatment for their patients. If you are experiencing symptoms of dry eyes, such as discomfort, burning, itching, or redness, it is important to seek medical attention and undergo appropriate testing to determine the underlying cause of your symptoms and develop an effective treatment plan.
