Corneal ulcers and infections

Shirmers test
Table of Contents
Alternative names Defination How the test is performed	Prepration for the test How the test will feel Risks How the test is performed	Normal Values What abnormal values mean Special Considerations
Alternative Names tear test; tearing test
Definition A test used to determine whether the eye produces enough tears to keep it moist.
How The Test is Performed The exact procedure may vary somewhat. Both eyes are tested at the same time. Most often, this test consists of placing a small strip of filter paper inside the lower eyelid (conjunctival sac). The eyes are closed for 5 minutes. The paper is then removed and examined for moisture. Sometimes a topical anesthetic in instilled into the eye before placement of the filter paper; this inhibits tearing that occurs because of irritation from the paper and ensures that only the basic level of tear production is measured. The tears may also be examined for their content of lysozyme, an enzyme normally found in tears. Fluorescein eye drops contain a dye that is placed in the eye. The dye should drain with the tears through the lacrimal duct into the nose. The dye should be cleared from the eyes and found in the nose within 2 minutes
Prepration for the test Remove contact lenses before the test. Infants and children: The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age: infant test or procedure preparation (birth to 1 year) toddler test or procedure preparation (1 to 3 years) preschooler test or procedure preparation (3 to 6 years) schoolage test or procedure preparation (6 to 12 years) adolescent test or procedure preparation (12 to 18 years)
How the test will feel Some people find that holding the paper against the eye is irritating or mildly uncomfortable.
Risks Essentially, there are no risks
How the test is performed This test is used when a person experiences very dry eyes or excessive watering of the eyes.
Normal Values A negative (more than 10 mm of moisture on the filter paper in 5 minutes) test result is normal. Both eyes normally secrete the same amount of tears.
What abnormal Values mean Dry eyes can occur from conditions such as: aging dehydration corneal ulcers and infections eye infections (for example conjunctivitis) vitamin A deficiency Sjogren syndrome secondary tearing deficiency (associated with disorders such as - lymphoma, leukemia, and rheumatoid arthritis) The inability of tears to drain into the nose can occur with: some eye infections blockage of the lacrimal duct
Special Considerations This test indicates the amount of tear production and/or ability to drain tears into the nose. It is not specific as an indicator of the cause of tearing difficulties such as dry eye. Close the eyes gently during the test. Tight closing of the eyes or rubbing the eyes during the test can cause abnormal test results. Do not rub the eyes for at least 30 minutes after the test. Contact lenses should be left out for at least 2 hours after the test.