Just curious everyones Schrimer's scores???

[untkicker29]

What are the scores of everyone's Schrimer test? I had the test done with an anestetic(spelled wrong) drop, and my left eye was an 8, and my right eye was a 5. I was told at least a 10 is what would feel normal.

[Lucy]

Mine have been

typically with a 5 minute test with anesthesia -1mm- each eye. Once I had a 2mm in the right eye, my better eye. I have been consistent in this test with different doctor's testing me using the same time and method.

[dianat]

Mine are within normal range now that I'm cauterized in all four punctae. I'm still extremely uncomfortable and burning much of the time. I do not tolerate any moving air. Scores mean little to me, as you can imagine.

[Erik]

0 left
1 right

Pretty consistent, but got a bit better when I was on the rebamipide (like 4 and 6).

I don't feel nearly as bad as those scores would indicate, though.

[untkicker29]

I was just curious because my right eye which is a 5 feels horrible at times, and my left eye can feel pretty bad too.

[Rebecca Petris]

I'd like to mention that Schirmer is a notoriously unreliable test because it's performed in so many different ways. Without getting into all the gory details, basically, you can't really get a falsely low score, but you can easily get a falsely high score depending how it's done.

Separately from that however, the vast range of Schirmer scores amongst patients with serious dry eye symptoms is one of the key issues which make "dry eye" so difficult to tackle effectively from a scientific/clinical perspective. Objective scoring often just does not correlate well with pain levels patients are experiencing. I was speaking with an ophthalmologist the other day who saw someone with a Schirmer of 15 in one eye and 25 in the other but was just going nuts with the pain. - Conversely, remember Erik's post awhile back when he was still on the Rebamipide study - quite noticeable objective testing improvements (TBUT etc) but from what I recall he also stated he wasn't actually feeling better.

Patients often find this an impediment to communication with their doctor. If their testing looks OK, it's hard to communicate severity of symptoms without sounding like one is exaggerating - when one is not! This is one of the reasons we strongly recommend the use of the OSDI questionnaire, because it's a scientifically validated way of "scoring" your ocular surface disease exclusively on the basis of its impact on your eye sensation, vision and activities.

[untkicker29]

I know it is unreliable in some aspects, but after having several different kinds of tests, my doctor came to the conclusion that I have just a lack of tears and the quality of them is fine. And so, I think in my instance the test is probably a good indicator of things. Also, I think when the tests is performed with a numbing drop, the results are more accurate, because I have had the test done without them, and my left eye showed a 15 and with that result I should feel no pain.
I understand how it can be misleading though for people with meibomian gland problems and other problems on top of just not producing enough tears.

[Rebecca Petris]

Quite - sorry, honestly wasn't questioning your (or anyone's) specific result. I mostly meant that the ones that technically score in the normal range (yours don't) can be false. Agree 100% re anaesthetising first. Helps to blot excess drops too.

[dianat]

Everybody's Schirmers scores make me look like such a wuss. I know my situation is strange. I am soaking wet all the time, but I do suffer...really, I'm not making this up! It's insane.

[Lucy]

Diana, that's the weirdness of this whole thing! You have (relatively) good scores, but burn miserably. Eric has the bottom of the barrel and "doesn't feel as bad as it sounds." I, have the bottom of the barrel readings and do feel miserable. Obviously, the tests and our reactions vary greatly.

I, do however, think the Schirmer's are of value. My lasik doc has always "excused" his negligence for NOT testing me for dry eye prior to lasik by saying the tests for dry eyes are not reliable. This gives the doc a false sense of security. I'd much rather he have tested me and we could have discussed the results together and made decisions. I did not have that opportunity. Only after lasik did I know what the hell a Schirmer's test was.

At least in my case, the test results are reliable. As Rebecca points out, a patient can have a false high reading because of reflex tears. But probably not a false low reading and those are the ones we should be looking at more closely. It's just too easy to dismiss the Schirmer's test as not reliable. It's about the only thing going, however flawed it might be. I'm sure some doctors say other tests are "not reliable" too. A cancer doc could say that mammograms are not reliable and just skip scheduling you for one on that basis. A pulmonologist could say that chest x-rays are not reliable and just skip it for that reason. You may have lunc cancer, but if the test isn't reliable--why even do it? I am being sarcastic here in case anyone wonders. If our doctors do not even try the Schirmer's, they have no point of reference, no matter how "unreliable."

[Gaye]

Schirmers test

No one ever actually told me my scores, but just said I basically had no tears at all. She had to wet my eyes to get the strips unstuck from my eyeballs. Back then, I didn't know much about dry eyes and didn't realize there were actually scores. I will have to get those results.

On a different, but interesting note, I took one of my cats to the vet the other day because he was getting this odd crusty stuff on his upper eye lids. The vet told me that this happens when an animal has a dry eye problem. She did a strip test, which I assume would be a Schirmers, test on him, and he was a 10 in each eye. The vet told me cats should have at least a 20 in each eye and that I needed to use moisture drops in his eyes. Good Grief! What next?! First me, now my cat. She also said they have a Restasis type of drop for animals. Unbelievable - and they can't tell you if it burns either.

[dianat]

Does your cat hiss when you instill those drops? I hissed at everyone when I used Restasis.

[Gaye]

Restasis for my cat

I know I hiss too when I use it, so I said I would use moisture drops, but not the Restasis type stuff on him. Dwelle might be perfect!

[dianat]

Dwell might be just what the vet ordered! I think it's a great idea.

[Gaye]

Feline Restasis

I am going to give it a try!