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Schirmer I test

Eye Care estimated about CNY 80-180

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Description

A diagnostic test measuring basal tear production without topical anesthesia, using filter paper strips placed in the lower eyelid for 5 minutes to assess aqueous tear secretion.

Main Uses

Primary diagnostic tool for evaluating aqueous-deficient dry eye disease; screening and monitoring severity in Sjögren’s syndrome and other autoimmune lacrimal insufficiencies; preoperative assessment for refractive or cataract surgery to identify dry eye risk; differential diagnosis between aqueous-deficient and evaporative dry eye subtypes (often combined with tear film break-up time and meibomian gland evaluation); and objective documentation of tear production impairment in clinical trials and longitudinal management.

Normal Range

Schirmer I test measures baseline (unstimulated) tear production over 5 minutes using a standardized filter paper strip. Normal value: ≥10 mm of wetting in 5 minutes. Values 5–9 mm indicate mild to moderate aqueous tear deficiency; <5 mm indicates severe deficiency. Age- and gender-adjusted norms apply: healthy adults typically produce 10–15 mm; older adults (>65 years) may average 8–12 mm; females often show slightly lower values than males.

Low Values - Possible Causes

Sjögren’s syndrome, aging-related lacrimal gland dysfunction, chronic blepharitis or meibomian gland dysfunction (secondary aqueous deficiency), systemic autoimmune diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus), long-term contact lens wear, certain medications (e.g., anticholinergics, antidepressants, antihistamines, beta-blockers), radiation therapy to the head/neck, and idiopathic dry eye.

High Values - Possible Causes

Reflex hypersecretion due to ocular surface irritation (e.g., corneal abrasion, foreign body, trichiasis, allergic conjunctivitis), acute bacterial or viral conjunctivitis, exposure keratopathy (e.g., lagophthalmos, facial nerve palsy), post-surgical inflammation (e.g., after LASIK or cataract surgery), and environmental triggers (e.g., wind, smoke, low humidity causing compensatory tearing). Note: Schirmer I is not designed to assess reflex tearing; high values are uncommon and usually reflect confounding irritative stimuli rather than true hyperlacrimation.

Schirmer test dry eye diagnosis tear production test ocular surface assessment aqueous tear deficiency

estimated about CNY 80-180