Overview

Schirmer's Test is a diagnostic procedure used to measure tear production and diagnose dry eye syndrome. It is a simple, non-invasive test performed in the clinic.

Schirmer's test is crucial for diagnosing dry eye disease and monitoring treatment response. It helps differentiate between aqueous-deficient and evaporative dry eye.

Learn more in our comprehensive RxDx Ophthalmology Course

Indications

✓
Dry Eye Disease

Diagnosis and monitoring

✓
Keratoconjunctivitis Sicca

Assessment of tear production

✓
Lacrimal Gland Dysfunction

Evaluation of tear secretion

✓
Pre-operative Assessment

Before ocular surgery

✓
Contact Lens Intolerance

Assessment of tear film

Contraindications

Absolute Contraindications

✗ Patient refusal
✗ Active eye infection

Relative Contraindications

✗ Recent eye surgery
✗ Severe photophobia

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes explaining the procedure to patient, ensuring proper positioning, and preparing test strips.

Step-by-Step Procedure

Step 1: Patient Preparation

Explain procedure, position patient, prepare strips.

⚠️ Common Mistakes to Avoid:

  • Inadequate explanation
  • Poor positioning

💡 Pro Tip:

Explain that the test may cause mild discomfort.

Step 2: Test Administration

Place strip in lower fornix, start timer.

⚠️ Common Mistakes to Avoid:

  • Wrong placement
  • Incorrect timing

💡 Pro Tip:

Avoid touching cornea.

Step 3: Result Measurement

Remove strip after 5 minutes, measure wetting.

⚠️ Common Mistakes to Avoid:

  • Incorrect measurement

💡 Pro Tip:

Measure from notch to wet edge.

Step 4: Documentation

Record results and discuss with patient.

⚠️ Common Mistakes to Avoid:

  • Poor documentation

💡 Pro Tip:

Document both eyes separately.

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Post-procedure Care

Post-procedure care involves documenting results and discussing management if abnormal.

Complications & Management

Complication Incidence Signs Management Prevention
Patient discomfort Common Foreign body sensation Reassurance Gentle technique
Reflex tearing 5-10% Excessive tearing Repeat test Minimize irritation

Clinical Pearls

💡

Explain that the test may cause mild discomfort.

🎯

Avoid touching cornea.

⚡

Measure from notch to wet edge.

📊

Document both eyes separately.

⚠️

Reflex tearing can affect results.