The Schirmer test is used to test aqueous tear production.
The test is performed in dim light with fans switched off.
Whatman filter paper no.41 is used with a dimension of 5 mm x 35 mm.
1. The test is performed by instilling a topical anaesthetic.
2. The 5 mm tab is folded at one end and then the bent end is placed at the junction of the lateral 1/3rd and medial 2/3rd of the lower conjunctival sac.
3. The corners of a soft tissue paper may be used to wick all liquid from the inferior fornix by capillary attraction without any wiping or direct irritation before the paper is placed.
4. The patient's eyes are then closed for 5 minutes, and the amount of wetting in the paper strip is measured.
5. Less than 5 mm of wetting is abnormal; 5-10 mm is equivocal.
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