Comm Eye Health Vol. 24 No. 76 2011 pp 45. Published online 01 December 2011.
Schirmer’s test
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Before performing any eye procedure
- Wash your hands (and afterwards too).
- Position the patient comfortably with head supported.
- Avoid distraction for yourself and the patient.
- Ensure good lighting.
- Always explain to the patient what you are going to do.
Reasons for Schirmer’s test
To record measurement of tear secretion in patients with suspected ‘dry eyes’.
![Figure 1 © Murray McGavin & Sue Stevens](http://s160131.gridserver.com/wp-content/themes/cehj-theme/img/grey.gif)
You will need (Figure 1):
- Schirmer’s test strips
- Watch or clock
- Clear adhesive tape
- Pen.
Preparation
- Explain to the patient that although this procedure may be uncomfortable, it is not painful.
Remember: Do not instil any anaesthetic drops or other eye medication before the test. This would give a false result.
Method
- Remove two strips from the sterile packet and label them ‘R’ (right) and ‘L’ (left) (Figure 2).
- Bend each strip, at the notch, to a 90 degree angle (Figure 3).
- Ask the patient to look up and, with an index finger, gently pull down the lower eyelid.
- Hook the bent end of the strip over the centre of the lower eyelid and allow it to ‘sit’ inside (Figure 4).
- Repeat the procedure for the other eye.
- Note the time (Figure 5).
- Ask the patient not to squeeze, but just to keep the eyes gently closed.
- After five minutes, ask the patient to open both eyes and look upwards.
- Carefully remove both strips.
- Using the package scale, measure the length of the moistened area on the strip, from the notch, and indicate this with a pen mark (Figure 6).
- Stick the strips into the patient’s documentation and record the measurements below each strip, e.g., “10 mm in 5 minutes”. If the strips are completely moistened before five minutes, record appropriately, e.g., “30 mm in 3 minutes”.
![Figure 2 © Murray McGavin & Sue Stevens](http://s160131.gridserver.com/wp-content/themes/cehj-theme/img/grey.gif)
![Figure 3 © Murray McGavin & Sue Stevens](http://s160131.gridserver.com/wp-content/themes/cehj-theme/img/grey.gif)
![Figure 4 © Murray McGavin & Sue Stevens](http://s160131.gridserver.com/wp-content/themes/cehj-theme/img/grey.gif)
![Figure 5 © Murray McGavin & Sue Stevens](http://s160131.gridserver.com/wp-content/themes/cehj-theme/img/grey.gif)
![Figure 6 © Murray McGavin & Sue Stevens](http://s160131.gridserver.com/wp-content/themes/cehj-theme/img/grey.gif)