A Review of the Schirmer Test for Tear Production

Abstract

Schirmer, in his original report¹on lacrimation, used blotting paper to collect tears elicited by one of the following 3 methods of stimulating lacrimation: (1) inserting the strip of paper itself; (2) irritating the nasal mucosa after the cornea had been anesthetized, and (3) having the patient look into the sun. After considerable study he decided to concentrate on the first method, and since then all subsequent studies have been based on this method. In the few studies reported since then, deRoetth^2-4used Whatman standard No. 41 filter paper in the form of a strip measuring 35 by 5 mm. At one end, a 5 mm. length of the strip is bent over and inserted over the outer half of the lower lid for 5 minutes. The amount of paper moistened is reported. He showed that in general after the age of 50 years there was a progressive