The Schirmer test is a simple measurement of tear production using small strips of filter paper placed inside the lower eyelid. It helps assess aqueous tear deficiency.
Procedure
After gently inserting the strips at the outer lower lid margin, the eyes are closed for a set time, typically five minutes. The length of paper wetted by tears is then measured in millimetres.
- May be performed with or without topical anaesthetic, depending on protocol
- Low wetting values suggest reduced tear secretion
- Reflex tearing or discomfort can affect results
- Both eyes are usually tested simultaneously
Clinical Use
The Schirmer test is commonly used in diagnosing Sjögren’s syndrome and other causes of aqueous-deficient dry eye. It is interpreted alongside symptoms and other tear film assessments.
- Helps distinguish aqueous deficiency from primarily evaporative dry eye
- Serial tests may monitor changes after treatment
- Variability between tests means results are considered in context
- Often combined with ocular surface staining and tear break-up time
