Osmolarity and Schirmer tests

[browneyesblu]

I have been reading about these on this site and am wondering how do I go about getting them done? Two eye doctors have looked at my tear film with stain and told me it was good, yet I am very symptomatic (tearing, vision fluctuation, photophobia). How do I go about finding someone who does this testing. Anywhere in NY Metro area would work.

[spmcc]

Schirmer's test and TBUTs (along with dye) are standard tests that any ophthalmologist would do. But I suppose you could specifically request these tests if the doctor wasn't going to do them.

For Tearlab's Osmolarity test, you can look for a doctor's location using their website: http://www.tearlab.com/contact/finddoctor.htm

Good luck.

[Rebecca Petris]

Some doctors don't, or rather won't do Schirmer because of reliability concerns or they feel they can adequately assess tear volume other ways. If you do get Schirmer, pay attention to whether you are anaesthetized beforehand or not. Ideally, get it done both with and without anaesthetic. They are assessing two different things.

Personally I'll never let anyone schirmer me again (shudder). Hurts me too dang much, and I'd trust a good doc to figure it out without that strap.

[browneyesblu]

Many thanks for your responses. I'll ask my doctor about them.

[No tears in ATL]

Thanks for the info Rebecca. They put the numbing drops in with me and I had a sneaking suspicion it was going to throw things off. Now I know why doc said, "according to this test your tear production is normal." Yea, right!!

[DCRdryeye]

An ophthamologist I visited told me the schirmers test is useless. But I'd take his word with a grain of salt since he was the rudest eye doctor I've seen and he dismissed I had dry eye despite countless other doctors confirming I do.

[spmcc]

Wikipedia's page on Schirmer's test says

Even though this test has been available for over a century, several clinical studies have shown that it does not properly identify a large group of patients with dry eyes. Newer and better tests of tear production and function are now emerging.

* One test measures an iron-binding molecule called lactoferrin. The amount of this molecule appears to be closely related to tear production. Patients with low tear production and dry eyes have low levels of this molecule. This test may be especially valuable for patients with dry eyes since it can point to specific treatment strategies for dry eye.

*The tears may also be examined for their content of lysozyme, an enzyme normally found in tears.

*Another test involves fluorescein eye drops, which contain a dye that is placed in the eye. The dye should drain with the tears through the lacrimal duct into the nose within 2 minutes. If patients do not have enough tears to flush the dye into the nose, this time will be longer. A new test is also available to more accurately measure the flow of dye out of the eye.

Unfortunately, if the are puncta sealed (I have all four cauterized) and the doctor uses dye, he obviously won't see any dye draining!

I guess the point is --- there are lots of tests. I would hope that a doctor would do them ALL to help figure out what the problem is!!