Schirmer Tear Test


The Schirmer Tear Test, named after Otto Schirmer, is used to evaluate whether the eye is producing enough tears to keep it lubricated. The test is usually performed when an individual experiences either excessively dry or watery eyes for a long period of time.

The Schirmer tear test involves placing a small piece of filter paper (special paper that soaks up water) onto the surface of the eye, usually below the lower eyelid for a period of 5 minutes. Prior to inserting the paper, a small amount of local anaesthetic eye drops are used to prevent any irritation from the paper. When removed, the distance moisture has traveled along the filter paper is indicative of tear production. Normally a filter strip from a healthy young adult will show moisture having moved approximately 15-20 mm over a 5 minute time period. The production of tears declines over time and as such about one third of older patients should expect to see around 10mm of fluid on their strips.

Determining the results of the test – Over a 5 minute period

  • Normal = more that 15mm
  • Mild = 9 to 14mm
  • Moderate = 8 to 4mm
  • Severe = less than 4mm

The Schirmer test has been used in clinics for a long time, however now, new and improved tests are becoming available. Currently, there are 2 new tests available. One involves measuring a molecule called lactoferrin, which is directly involved in tear production. The second involves using a fluorescent dye to measure the drainage of tears out of the eye.

All of the tests outlined above are designed to highlight patients who have problems with tear production. This can be due to problems with tear drainage, eye damage or conditions such as Sjogren’s syndrome.


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