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  • Schirmers score question

    Hi there,
    Does anyone know whether a schirmer score can be affected by putting in eye drops prior to placing the strip in the eye(like 30-40 mins before hand)
    Once,in my docs office i scored a 5 for both eyes without anaesthesia.
    Recently,i scored a 30 in my right eye and 20 in my left eye(It had been an hour beforehand when i put 4 drops into my left and 40 before my right)
    this wa also unanaesthetised.
    Im starting to feel like this test is a complete waste of time!
    Many thanks
    A

  • #2
    Schirmer's

    The last time I was at the eye doctor they asked me when was the last time I used lubricant eye drops. And they said it had to be at least 30 minutes since I used my last eye drop or the Schirmer's would be inaccurate.

    Just to let you know some of my scores:

    first: 3 in both eyes

    a couple weeks later: 30+ in both eyes (more than the test can show)

    a couple weeks later: 15 in both eyes, then repeat with more anesthesia, 8 in both eyes

    So, I also am having issues with the schirmer's although I can accept that having had dry eye for almost a year now, maybe my lacrimal gland output is going down? Anyway, I think I am going to punctal plugs soon...

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    • #3
      My ophth. says that celluvisc drops stay in the eye for about 40 minutes, so putting them in an hour before shouldn't have affected the result, I don't know if the gel types may persist for longer. I would agree that the Schirmer's test isn't 100% reliable, but is just one of a number of tests an eye doctor may do to try to get a fuller picture of what's going on with your eyes.

      The first one I had done was by a rather inexperienced rheumatologist, who put the strips in very roughly, causing pain and reflex tearing. She didn't tell me the exact result, just that it was 'ok' (presumably because the eye-watering discomfort had skewed the result). When the ophth. did it (without anaesthesia) she was much more careful and the result did show severe dryness in one eye; the score was higher in the eye more prone to pain/watering, but she was still happy to make a diagnosis of severe dryness in both eyes based on the degree of staining / condition of the eye surface.

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      • #4
        I think an hour out you're probably safe. My specialist has never told me not to put drops in that far in advance but while I'm sitting in the chair, he does NOT like me to put drops in. I'm not sitting there for an hour prior to any testing though.

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        • #5
          Originally posted by Anthony16 View Post
          Im starting to feel like this test is a complete waste of time!
          I think you got that right.

          Even in ideal circumstances where the conditions can be exactly replicated, Schirmer results are not all that reliable. There are certainly better diagnostic tests out there.

          y-gwair: OMG, your rheum did a Schirmer? I didn't know anyone other than an eye doc would do this. I won't even let an eye doc do it to me any more because it's too painful and pointless.
          Rebecca Petris
          The Dry Eye Foundation
          dryeyefoundation.org
          800-484-0244

          Comment


          • #6
            Originally posted by Rebecca Petris View Post
            y-gwair: OMG, your rheum did a Schirmer? I didn't know anyone other than an eye doc would do this. I won't even let an eye doc do it to me any more because it's too painful and pointless.
            With hindsight, I'm quite angry about it, as I say without being able to look at the state of the eye properly, it was pointless, painful and actually very misleading.

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            • #7
              I think the same. I got 19 and 17. But when she put the strips in my eyes, my eyes produced soo much reflex tears. Is the point of this to measure the reflex tears? She did put in drops prior to this, whitch did make my pupils cover the blue in my eyes, if you know. I remember going home after this, it was sun and snow on the ground. That hurt. When I got home, I had to turn of some of my lights:P
              The cure: be open minded

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              • #8
                My last test I requested to see if restatis and other drops were helping me produce tears. One eye was 0 and the other eye 30, the doctor thinks the 30 was al reflex tears and that the 30 eye really is 0 also.

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                • #9
                  The opth I saw a few weeks ago did the test and I got a two in my right and a 6 in my left. The opth I saw 3 days ago( for a much needed second opinion due to my gut feeling of not trusting the first "specialist") said she never does Schirmers tests. Says there's no point and that she can tell all she needs to know from other forms of examining my eyes. I believe her and I too think it is pointless and a waste of time.

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                  • #10
                    Is this schimer test is not accurate, how do we monitor our DES progress, is it is improving or deterrioting?

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                    • #11
                      Seeing as how the Schirmers test is clearly not too accurate, I'd say by regular exams with an opth and by the way you feel.

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