The Schirmer test is used by ophthalmologists to analyze tear fluid and the quality of its products.For these purposes, a strip of fine litmus paper is used - it is wound up behind the lower eyelid for about 5 minutes, after which it will be possible to assess the quality of tearing. According to the results of the test, the doctor confirms the presence of dry eye syndrome or another diagnosis. We remind you that the dryness of the eye can develop for various reasons - as a result of taking certain medicines, the presence of various chronic diseases and under the influence of other external, internal factors. Read more about taking samples.
Content
1Method definition
2Application area
3Procedure
4results
5Video
6conclusions
Method definition
The trial of Schirmer assumes a neat establishment beyond the end of the century (it's more convenient to do these manipulations with the lower eyelid) eyes of thin paper strips.Some doctors ask the patient to close their eyes during the study, while others sit up straight and look up.
The research is carried out in different ways - some doctors ask the patient to keep their eyes completely closed, while others open and look up.
After five minutes (approximately), after the test strip is placed, the zone of its moistening is evaluated.The distance is considered to be 10-30 mm, but in elderly people this indicator may be lower. Considered is the total tear production, which consists of two parts - the main and the reflex.Assess the results of the test should only the doctor.
Application area
The Schirmer test is used for:
research and analysis of the quality of lacrimal fluid production;
diagnosis of dry eye syndrome.Dry eye syndrome
Because dry eye syndrome is a disease associated with the production of tear fluid, then in addition to it, other diseases and factors can influence its secret. They include:
Chronic overtaxation of the eyes by means of a long time in front of the monitor.
Long-term use of vasoconstrictive drops for the eyes.
Improperly selected moisturizing drops.
Midria, miotiki can cause dry mucous. Antibiotics for prolonged use or incorrect dosage cause burning and itching, which in the future is fraught with dryness.
Dystrophic changes in the lacrimal canal.
Atresia of canals.
Stenosis of the nasopharynx.VisOptic - vasoconstrictor drops
Dry eyes develop as a result of Sjogren's pathology, medication, dry air, etc.
Procedure
To take a sample, the doctor bends the end of the strip of special thin paper and winds it beyond the edge of the lower eyelid.The paper begins to absorb the pre-corneous film and liquid from the so-called lacrimal lake. Typically, an interval of 5 minutes to evaluate the results is sufficient. If a person suffers from the dryness of the eye, the amount of tear that the paper strip absorbed will be low or generally zero.
Zero imbibition of tears is a complete lack of absorption.
If the tear film is deficient, the test gives zero or simply very low results.Normally, the paper strip should get wet at least 10 mm.
The sample can be taken with anesthesia (using drops) or without it.
The Schirmer test can be performed with or without anesthesia.When is anesthesia necessary? In those situations where contact with the strip causes reflex lacrimation, the pathology is masked. To prevent reflex reaction it is possible, if to drip before an investigation in an eye anesthetic.
Burying drops with an anesthetic effect prevents the development of reflex lacrimation - a response to the irritant effect of the paper strip on the conjunctiva of the eye.
Without anesthesia, the test should be performed better - in this case only tears will be taken into account (with the use of anesthesia, the paper gets wet, including due to the drug).The results are evaluated immediately, taking into account the patient's age (for the young and elderly people the norms are different). If necessary, additional studies can be conducted in combination with subjective clinical symptoms.
The degree of dryness of the eye can be different. To determine it, additional diagnostic techniques are used.
results
The sample is positive if the patient under the age of 60 years has received a result of up to 10 mm.In this case, for people in the older age, this result will be normal (and the sample, respectively, negative).
The indicator is less than 10 mm - the norm for the elderly and not the norm for young patients.
If patients under the age of 60 years, the study of tear fluid which was conducted without anesthesia, paper the band is not soaked to the prescribed level, the doctor diagnoses dry eye (and its severity may be different).For a certain exact degree of dryness of the eye, other diagnostic techniques are usually used (they are determined by the doctor, taking into account the clinical picture).
Video
conclusions
The Schirmer test is a simple and effective method for studying tear fluid. The test is carried out using a thin strip of litmus paper, which will have to be wound on the edge of the century for 5 minutes. Results for patients older and younger than 60 years are evaluated in different ways - if the humidification zone is less than 10 mm is the norm in after 60 years, then at an earlier age this indicator is inadequate. The study can be conducted with or without anesthesia, with zero absorption of tears, it can be said that there is no absorption at all.
