Schirmer test

This measures the rate of aqueous tear formation by the lacrimal gland during a fixed time period.

• performed by instilling a topical anaesthetic and then absorbent paper strips are placed with one end in the inferior cul-de-sac
• patient’s eyes are closed and the length of paper wetted in 5 minutes measured
• value of less than 6 mm of strip wetting in 5 minutes is accepted as diagnostic marker for aqueous tear deficiency
• Schirmer II test measures tear of lacrimal gland by stimulation of lacrimal relex arc while Schirmer I test (without use of a topical anaesthetic) measures both basic and relex tearing (1)

Reference:

• (1) Phadatare SP et al. A Comprehensive Review on Dry Eye Disease: Diagnosis, Medical Management, Recent Developments, and Future Challenges.  Advances in Pharmaceutics 2015, Article ID 704946