Schirmer's test.

Sue Stevens

Wash your hands (and afterwards too). Position the patient comfortably with head supported.

Avoid distraction for yourself and the patient.

Ensure good lighting.

Always explain to the patient what you are going to do.

Reasons for Schimer's test

To record measurement of tear secretion in patients with suspected ‘dry eyes’.

Schirmer's test strips

Watch or clock

Clear adhesive tape

Pen.

Explain to the patient that although this procedure may be uncomfortable, it is not painful.

Preparation

Remember: Do not instil any anaesthetic drops or other eye medication before the test. This would give a false result.

Remove two strips from the sterile packet and label them ‘R’ (right) and ‘L’ (left) (Figure 2).

Bend each strip, at the notch, to a 90 degree angle (Figure 3).

Ask the patient to look up and, with an index finger, gently pull down the lower eyelid.

Hook the bent end of the strip over the centre of the lower eyelid and allow it to ‘sit’ inside (Figure 4).

Repeat the procedure for the other eye.

Note the time (Figure 5).

Ask the patient not to squeeze, but just to keep the eyes gently closed.

After five minutes, ask the patient to open both eyes and look upwards.

Carefully remove both strips.

Using the package scale, measure the length of the moistened area on the strip, from the notch, and indicate this with a pen mark (Figure 6).

Stick the strips into the patient's documentation and record the measurements below each strip, e.g., “10 mm in 5 minutes”. If the strips are completely moistened before five minutes, record appropriately, e.g., “30 mm in 3 minutes”.