Schirmer score

[Delta]

Anyone know their Schirmer scores and what it means?

I have both upper and lower plugs and my score was about 4 mm few years ago and now about 8-10mm after 4-5 minutes without anesthetic.

I would think if my eyes were not dry, with both upper and lower plugs. the tearing would be massive and just over flowing like Niagra falls. Actually that sounds good. If I could just live under the Niagra Falls and have wet eyes all the time...... back to reality.

So anyone have scores and could you share them?

Thanks

[Rebecca Petris]

Anyone know their Schirmer scores and what it means?

I have both upper and lower plugs and my score was about 4 mm few years ago and now about 8-10mm after 4-5 minutes without anesthetic.

Doing a Schirmer without anaesthetic means you're getting all the reflex tears from irritation from the strip. That's a useful measurement too if you're very dry, but I think a much more important measurement is the basal tear production. They need to anaesthetize you for that. I score just fine on an unanesthetized Schirmer but... I'm still very dry.

[bernmee]

Yes, I have only been tested with an anesthetic, otherwise the irritation produces tears.

I came back yesterday with a whopping 30mm, but my TBUT is 7 second, and for me the tear evaporation is the problem.

B.

[dan_can]

Scores

With an anesthetic : 8mm and 10mm
Without: 21mm and 30mm
TBUT : it has been 5, 7... never over 10 seconds

My doctor said if one goes up, the other does too... (???)

[Delta]

Could you tell me little about how the evaporation process? What is causing the evaporation problem?

I had basal rate checked but was low around 2-3 mm. Still should not be causing so much pain and discomfort-- I would think.

I know when I slept with contact lens in before and woke up dry as bone. I would take the lens out and everything was normal. Not now. That is an example of how mine feels all the time.

I would be very interested in learning about how other's eye feels.

By the way, thank you Rebecca for reply. I do appreciate your effort and energy in keeping this website accessible to all of us in need.

[bernmee]

I think your rate is low. I have a rate of 30mm and am still in pain.

The oil glands are located in the inner rim of your eye lids. They release oil when you blink, and spread the oil accross your eye. If you are not producing enough oil then those tears in your eye are evaporating too fast, leaving you with "dry eye".

In my case it is from MGD, while I could have had this the whole time and not felt anything I feel it now after Lasik.

The Tear Break Up Time measures how quick your tears evaporate. If you have lots of oil then it should take longer. I think you are looking for more then ten seconds, though it probably depends on the person.

This is my understanding of it.

I have a result of 7 seconds, that I think would be relatively good, what with my high tear production, but I stil have pain.

[Delta]

Thank you very much for your comments.

Could you tell me more about your pain? I am trying to determine if my pain is same type as what others have.

Mine is fairly severe. I wake up and first thing I notice is that my eye is not normal. I have this very painful and uncomfortable sensation as I roll my eye inside of my closed lids. And so on all day.

Could someone share how the eye feel? Is it just dry feeling? Or is it pain? Why does dry eye cause pain?

Has anyone slept with the contacts in and wake up with dry eyes--- and is it that type of pain or dryness?

Mine feels exactly like the time when I had hard contacts in and I was in hot summer day in desert. I had no way to take my lens out. It felt like the lens was going to melt into my eye. I had such pain and dryness I finally had to take the lens out and just hold them while I walked. My eyes felt fine when i took it out. But now I am not wearing the lens but feels similar type of pain and dryness. Anyone else experincing that type of pain? I would appreciate any descriptions.

[bernmee]

I have included this link that I think you might be interested in

http://www.dryeyezone.com/talk/showthread.php?t=6985

I have two types of pain.

The first type of pain, I thought was on the bootom of my eyeball, but I have just realised, and was told by my Dr. two days ago, that it is my eyelid that covers the bottom of my eye that is sore. It is imflammed. It feels like I have a string of pasta or a noddle tucked in there. It is horrible but I can sometimes control it. This is the pain I have most of the time now. I have MGD. People with rosacea (flushed red faces often have ocular rosacea or MGD)

Right after my lasik and before I started getting the proper help the pain I had, in addition to the above pain a second pain. It was like there was sunscreen in my eye, or chlorine from a pool, but no tears to wash it away. It burned and stung. It also felt like a cockroach had burrowed into the edge of my eyeball, and I could feel his back sticking out, I guess this is called "feeling of foreign sensation". Sometimes it felt raw like a washer women's hands at the end of a days work. Othertimes like someone had punched me in the eye. It would bounce from one to the other in the space of an hour, with no let up. I am now wondering, and will ask my Dr. at the next appointment if this pain is caused by "dry spots" on the cornea.

Thankfully I only get this pain every 10 days or so, usually only for a couple of days at a time. The first pain I have most of the time, but I hope to get on top of that too.

Dry eye is a catch all phrase used to describe many conditions. But the result is the same, pain. I think, though I am no expert on this, that the tear film is supposed to protect our eyes, moisturise them, nourish them, protect them. When the tear film is compromised, for what ever reason, the eyeball or cornea is not getting what it needs and it reacts. Normal really. I have read that the cornea is the place on the body with the highest density of nerves. So if it is not happy it is going to let you.

I'm sure if you search around you will be able to get a better medical explanation. I would recommend you get and read the book by Dr. Robert L. that is for sale in the dryeyestore. I borrowed it from the library but am going to reorder it because as I go on I have more and more questions. So much is answered in that book.

Delta, I don't know what you are using in terms of drops etc as you don't have anything in your profile. But I would advise you to get some drops in your eyes before you open them in the morning, and then roll your eyes around.

Did you overuse your contacts. In the book he deals with some situations where over use of contacts were the cause of dry eye. He also explains what caused the dry eye. I never really wore contacts so I didn't take more then a passing interest.

Good luck,

B.

[Delta]

Thank you for your post. However do you know why lasik surgery would disrupt your oil gland production?

For that matter, why cutting some nerves during lasik surgery would cause decrease oil production in some person and not others?

Also do you ever experience my type of pain--- sensation of dryness and pain like you would have after sleeping with hard contacts and waking up with it?

I have dryness but the doctors does not know why. I did use to wear contacts for long periods when I should not have. I have been through all kinds of tests and like all of you experienced a range of emotion from anger to total despair.

Your situation seems very encouraging as you have high schirmer score. I am sure things are going to work out slowly over next few months.

If your scores are that high do you still have the plugs?

Thanks

[bernmee]

http://www.dryeyezone.com/talk/showthread.php?t=7013

Above is a thread about MGD and Lasik. Dr. Robert L. deals with some cases of dry eye brought on by excessice use of contacts, in fact if I remember correctly he says you need at least two days break per week so your eyes don't get damaged. I think he said that the nervs can be damaged by excessive use, which I guess would do almost the same thing as as Lasik does, and in some people then could go on to cause MGD. He gives a btter definition.

Why do some people suffer after Lasik and others don't. I have no idea. Maybe it has somehthing to do with how prone a certain person is to inflammation. I don't think there is enough public awareness of dry eye. I always thought it meant you had to use eye drops every now and again. Boy was I wrong. I think if it was known then they would have a better chance at proper screening. But as things stand, with the FDA not requiring reporting of cases like me and so many others, and the public not knowing about what can happen after Lasik, and so many Dr.'s having so much money tied up in Lasik, I don't see anything changing soon. I'm sure it will, but that is another matter.

I never really wore contacts, I was always funny about touching my eyes, and when I did it was only for a couple of hours at a time, so I can't relate to your pain. But all our pain is different depending on our scores/diet/nerves and all other types of things I'd imagine.

And yes my plugs need to stay in. Without them I would have the tears evaporating too fast and my tears draining. That would be double trouble.

And I agree, I am soooo lucky to have a high Schirmer score. At least I only have one things to worry about, and I'm hoping once I get it back in check it will stay that way, as I will have the tears to support it.

I am still learning about this whole dry eye thing, but I hope this can help.

Bernadette

[Delta]

Thank you for the post. If you have plugs in, do you get lots of overflows with high schirmer score then? Do you have to wipe away excesisve tears often?

Sometimes I have to do that often especially after eating. It is such cumbersome. Sometimes I cam talking with friend and I start welling up and I have to find something to wipe it before it starts to roll down.

Also is there anyone with real low Schirmer score like mine? I would appreciate any post

Thank you.

[bernmee]

Hi,

No I don't get any overflow. I have had an occasion had a tear fall out, like a couple of times over the months, but when that happens I usually show it to whoever happens to be around, if I know then that is. My tears just evaporate too quickly because I have MGD.

I think for many post Lasik people, and maybe others to, we presume that because our eyes are dry it means that they don't have tears to start with. Plat posted an started an excellent thread with two videos from youtube regarding "dry eye". Have a look at it.

I think I am in the minority with much a high schirmers, and a nice minority at that. Many people on this site have very very low scores, and I believe there are more then a couple who come up 0 on that test.

[Lucy]

Also is there anyone with real low Schirmer score like mine? I would appreciate any post

Delta, I am zero Schirmers in both eyes under anesthesia 5 minute controlled testing. I was dx with Sjogrens 2 years ago and my eyes will not "heal" and time has made it worse. I had lasik 9 years ago and that started my dry eye problem.

I used to be 3mm and 5 mm years ago. Then I was 1mm and 3 mm. I had all 4 plugs at one time. I also went through the overtearing process to which you refer: when you're eating, or talking to someone. This was a problem for awhile, then it stopped slowly over time. To sum up, the over-tearing may clear up over time. Many people have their plugs removed during this problem and then are sorry because their eyes are back to being too dry. Good luck, Lucy.

[Delta]

Hi Lucy, it seems that your symptoms and condition is most close to mine.
I do not have Sjogrens but very dry eyes. I have still functioning lacrimal glands but it seems the glands in my eyelids and the surface of my eyes are not working.

I have swollen upper eyelid and also my eyeballs feel full all the time. The pressures have been always normal. Also my vision is very light sensitive to point of feeling outside in the sun even when it is not.

I am trying to find out it the dry eys are causing vision changes and swollen upper eyelid or if something else. Anyone with dry eyes have visiual changes also? I would appreciate any post about it. I am just not sure if all my symptoms are dry eye related or something else.

Lucy I do feel significant compassion for you. It must be so painful to get through everyday with such low tear flow.