Introduction

The Schirmer Tear Tests (Schirmer I Tear Test, Basic Tear Secretion Test) are used to grossly measure tear volume under different conditions.  Schirmer I is used to measure reflex and basal tear volume.  The Basic Tear Secretion Test is used to measure basal tear volume (without reflex component).  They are tools that can be used as part of a dry eye workup.

Indications

Patient complaint of dry eyes or suspected dry eyes

Contra-Indications

Allergy to topical ocular anesthetic, if used.

Materials

1. Schirmer Tear Test strips
2. Topical ocular anesthetic, such as proparacaine 0.5%

Setup

Schirmer Tear Test I

1. Open the package, and remove one of the two strips.
2. Fold the rounded end of the strip down.
3. Slightly pull down the lower lid and hook the strip over the lower lid margin, approximately 1/3 of the way from the lateral canthus.  Repeat for the other eye, and then have patient gently close their eyes.
4. Begin timing.  After five (5) minutes (or when the strips are totally saturated), pull the lower lid down and remove the strip by moving it slightly upward and away from the eye.  Repeat for the other eye.
5. Measure the amount of the strip that has been moistened from the fold.  Record in mm.

Basic Tear Secretion Test

1. Instill one drop of topical ocular anesthetic in each eye, and wait a few minutes for it to take effect.
2. Perform Schirmer Tear Test I as above
3. Measure the amount of the strip that has been moistened from the fold.  Record in mm.

Results

A result of 0 mm to 9 mm can indicate a tear film deficiency

A result of 10 mm or greater is considered to be normal

References