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Drastic change in Schirmer’s scores

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  • Drastic change in Schirmer’s scores

    Hi everyone, I’m new to these forums, have been lurking over the past couple of weeks reading and learning everything I can about dry eyes.

    My dry eye saga started roughly 6 weeks ago when I started waking up every few days with inflammation in my right eye. It wasn’t very painful, just a bit irritated and red but it was reoccurring and annoying. After going to countless doctors I finally found an ophthalmologist who identified my dry eyes and was certain I had Sjögren’s Syndrome. She did the Schirmer’s test and my results were 1mm on my left eye and 0 on my right eye. She told me to use lubricating eye drops & night ointment and get blood tests done.

    I am still waiting for my blood test results but today I went to see another specialist about treatment options. She identified that my eyes were really dry but not severe. She redid the test and this time I had 9mm in my left eye and 4mm in my right (this is just 5 days after the first testing). She has however started me on an aggressive treatment plan, FML short term to reduce some lingering inflammation and Restasis. She said we would put plugs in during my next appointment when the inflammation had gone down.

    I just wanted to know whether other’s have had experiences where their Schirmer’s scores had changed so drastically in a short or longer period of time and how you are doing now - in particular I’d like to know, for those of you who are contact lens wearers, whether you were able to tolerate contact lens use after some time. I am very lucky in that although my eyes are dry, I do not feel any pain or burning or have watery eyes, my specialist said it is because my fat glands are working very well and shielding my eyes from the worst of it; my heart goes out to those who are suffering!

    Thanks in advance!!

  • #2
    Is it possible that the first doctor used anaesthetic eye drops before doing the test and the second doctor didn’t?

    If you already have dry eyes and someone puts a schirmers strip on your eye without any anaesthetic then there is going to be a lot of tearing up/watering due to the irritation so the result will be a couple of mms more than when not using anaesthetic.

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    • #3
      Schirmer is considered very unreliable and subjective by some medical professionals.

      MMP-9 and tear osmolarity testing are believed to be more reliable.

      My Schirmer scores are all over the place. LASIK dry eyes are my background.

      End of February 1mm and 2mm anesthetic applied first
      End of April 9mm and 14mm anesthetic applied fist
      End of May forgot anesthetic 7mm and 8mm, after anesthetic 10mm and 10mm!

      Make of that what you will.

      Of course, anything below 10mm isn't really healthy.

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