Schirmers

Schirmers typically refers to Schirmer's test, a standard diagnostic procedure in ophthalmology used to assess tear production and lacrimal function. The test uses filter paper strips, known as Schirmer strips, placed in the lower conjunctival fornix of the eye for about five minutes. The patient may blink normally, and in some variants anesthesia is used. After removal, the length of the strip wetted by tears is measured in millimeters. The result helps determine dryness of the eye and lacrimal gland dysfunction.

There are two main variants: Schirmer I, performed without anesthesia to measure basic tear secretion, and Schirmer II, performed with nasal stimulation to evaluate reflex tear production. Normal values and thresholds vary, but markedly reduced wetting—often reported as less than about 5 to 10 millimeters in five minutes—suggest diminished tear production. The test is simple and inexpensive but can be affected by environmental dryness, conjunctival irritation, topical medications, and technique, which can cause false positives or negatives. Therefore Schirmer's test results are usually considered alongside tear film breakup time, ocular surface staining, and patient symptoms.

Etymology and usage: The test is named after the physician who described the technique; the disposable paper strips are widely referred to as Schirmer strips. Beyond ophthalmology, the surname Schirmer is borne by various individuals in different fields.

Notes on interpretation and limitations: Schirmer's test provides a snapshot of tear production but does not directly measure tear quality or the overall quality of the tear film. It is often used as part of a broader dry eye workup and in conjunction with other diagnostic tests to guide management.