Indication of Schirmer Test – Indications, Procedures, Results

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 5 min read
Patient Tools

Read, save, and share this guide

Use these quick tools to make this medical article easier to read, print, save, or share with a family member.

Patient Mode

Understand this article easily

Switch between simple English and easy Bangla patient notes. This is for education and does not replace a doctor consultation.

Tear test; Tearing test; Dry eye test; Basal secretion test; Sjögren - Schirmer; Schirmer's test The Schirmer test determines whether the eye produces enough tears to keep it moist. How the Test is Performed The health care provider will place the end of a special...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Tear test; Tearing test; Dry eye test; Basal secretion test; Sjögren - Schirmer; Schirmer's test The Schirmer test determines whether the eye produces enough tears to keep it moist. How the Test is Performed The health care provider will place the end of a special paper strip inside the lower eyelid of each eye. Both eyes are tested at the same time. Before the test,...

Key Takeaways

  • This article explains How the Test is Performed in simple medical language.
  • This article explains How to Prepare for the Test in simple medical language.
  • This article explains How the Test will Feel in simple medical language.
  • This article explains Why the Test is Performed in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
Reviewed content workflowUse writer and reviewer profiles for stronger trust.
Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

3

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

Before reading

RX Patient Tools

Use these quick guides before reading the article, or return to them when you need help preparing questions for a doctor.

Start here Choose the right pathway for symptoms, reports, medicines, or urgent warning signs. Disease article roadmap Read this topic step by step: meaning, symptoms, warning signs, diagnosis, treatment, prevention, and follow-up. Treatment planner Prepare questions about treatment choices, benefits, risks, side effects, and follow-up. Family & caregiver guide Organize symptoms, reports, medicines, questions, and follow-up safely. Nutrition & diet guide Prepare food, hydration, supplement, and medicine-timing questions safely. Prevention guide Organize risk factors, protective habits, screening, and warning signs. Recovery guide Prepare a safe plan for activity, rehabilitation, warning signs, and follow-up.

Tear test; Tearing test; Dry eye test; Basal secretion test; Sjögren – Schirmer; Schirmer’s test

The Schirmer test determines whether the eye produces enough tears to keep it moist.

How the Test is Performed

The health care provider will place the end of a special paper strip inside the lower eyelid of each eye. Both eyes are tested at the same time. Before the test, you will be given numbing eye drops to prevent your eyes from tearing due to irritation from the paper strips.

The exact procedure may vary. Most often, the eyes are closed for 5 minutes. Close your eyes gently. Closing the eyes tightly or rubbing the eyes during the test can cause abnormal test results.

After 5 minutes, the doctor removes the paper and measures how much of it has become moist.

Sometimes the test is done without numbing drops to test for other types of tear problems.

The phenol red thread test is similar to the Schirmer test, except that red strips of special thread are used instead of paper strips. Numbing drops are not needed. The test takes 15 seconds.

How to Prepare for the Test

You will be asked to remove your glasses or contact lenses before the test.

How the Test will Feel

Some people find that holding the paper against the eye is irritating or mildly uncomfortable. The numbing drops often sting at first.

Why the Test is Performed

This test is used when the eye doctor suspects you have dry eye. Symptoms include dryness of the eyes or excessive watering of the eyes.

Normal Results

More than 10 mm of moisture on the filter paper after 5 minutes is a sign of normal tear production. Both eyes normally release the same amount of tears.

What Abnormal Results Mean

Dry eyes may result from:

  • Aging
  • Blepharitis
  • Climate changes
  • Corneal ulcers and infections
  • Eye infections (for example, conjunctivitis )
  • Laser vision correction
  • Leukemia
  • Lymphoma
  • pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।" data-rx-term="arthritis" data-rx-definition="Arthritis means joint inflammation causing pain, swelling, stiffness, or reduced movement. সহজ বাংলা: জয়েন্টের প্রদাহ।">arthritis: Rheumatoid arthritis is an autoimmune joint disease causing infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।" data-rx-term="inflammation" data-rx-definition="Inflammation is the body’s response to injury, infection, or irritation, often causing pain, swelling, heat, or redness. সহজ বাংলা: শরীরের প্রদাহ; ব্যথা, ফোলা বা লালভাব হতে পারে।">inflammation, pain, and swelling. সহজ বাংলা: রোগপ্রতিরোধ ব্যবস্থার ভুল আক্রমণে জয়েন্টের প্রদাহ।" data-rx-term="rheumatoid arthritis" data-rx-definition="Rheumatoid arthritis is an autoimmune joint disease causing inflammation, pain, and swelling. সহজ বাংলা: রোগপ্রতিরোধ ব্যবস্থার ভুল আক্রমণে জয়েন্টের প্রদাহ।">Rheumatoid arthritis
  • Previous eyelid or facial surgery
  • Sjögren syndrome
  • Vitamin A deficiency

Risks

There are no risks with this test.

Considerations

DO NOT rub the eyes for at least 30 minutes after the test. Leave contact lenses out for at least 2 hours after the test.

Even though the Schirmer test has been available for more than 100 years, several studies show that it does not properly identify a large group of people with dry eye. Newer and better tests are being developed. One test measures a molecule called lactoferrin. People with low tear production and dry eye have low levels of this molecule.

Another test measures tear osmolarity, or how concentrated the tears are. The higher the osmolarity, the more likely it is that you have dry eye.

FAQ

What does the Schirmer tear test measure?

  • Schirmer’s test is used to determine whether the eye produces enough tears to keep it moist. The test is performed by placing filter paper inside the lower lid of the eye. After 5 minutes, the paper is removed and tested for its moisture content.

What is a normal Schirmer tear test?

  • The normal rate of canine lacrimation established by Schirmer tear testing is in the range of 18.64 +/- 4.47 mm/min to 23.90 +/- 5.73 mm/min. It has recently been determined that these adult values are not attained until 9-10 weeks of age. Other research indicates that tear production may vary with a circadian rhythm.

What does a positive Schirmer test mean?

  • Schirmer’s test is primarily used to diagnose dry eye syndrome. This is a condition that occurs when the tear glands are unable to produce enough tears to keep the eyes moist. As a result, the eyes can’t get rid of dust and other irritants. This causes stinging, burning, and redness in the eye.

What is normal Schirmer?

  • Typically, 10–20 mm is considered borderline, and greater than 20 mm is typically normal. The Schirmer tear test uses a 5 by 35 mm strip of filter paper to measure basic and reflex tear secretion when used without an anesthetic. In theory, it measures only basic secretion when used with an anesthetic.

Is the Schirmer test painful?

  • Most people consider the test to be mildly irritating or uncomfortable. After the test, people should avoid rubbing their eyes for about 30 minutes. Additionally, they should not wear contact lenses for about 2 hours following the test.

How much does a Schirmer test cost?

Compare Similar Items

This Item – Schirmer Tear Test for Dogs, 5 packs of 2 strips (10 strips total) Add to Cart Insulin Vial Protector for Vetsulin or Humulin, Light Blue, 2 Pack Add to Cart
Customer Rating Rated 5 out of 5 stars 1 Rated 4.9375 out of 5 stars 16
Price $13.03 $14.99
Material N/A Silicone
Breed Size N/A N/A

How accurate is the Schirmer test?

  • Although this test is used frequently in the office, it has been found to lack accuracy and reproducibility: the same person’s test results taken at the same time each day for several days can fluctuate widely, and the mean Schirmer I test results for normal individuals have been reported to range from 8.1 mm to 33.1

What is the Schirmer 2 test?

  • Schirmer II test is performed by irritating the nasal mucosa with a cotton-tipped applicator prior to measuring tear production, which is mainly used for measuring the reflex tear secretion of the main lacrimal gland. S I has two branches: S I t without anesthesia and with topical anesthesia.

How many types of Schirmer tests are there?

  • There are two variations of the Schirmer test: Schirmer I measures total tear secretion (basal and reflex). Schirmer II is a measure of reflex secretion only and involves nasal stimulation following insertion of the strip.

What is the tear film of the eye?

  • The tear film is a thin fluid layer covering the ocular surface. It is responsible for ocular surface comfort, mechanical, environmental, and immune protection, and epithelial health and it forms a smooth refractive surface for vision.
Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Rest, drink safe water, and observe symptoms carefully.
  • Keep a written note of symptoms, duration, temperature, medicines already taken, and allergy history.
  • Seek medical care quickly if symptoms are severe, worsening, or unusual for the patient.

OTC medicine safety

  • For mild pain or fever, ask a registered pharmacist or doctor before using common over-the-counter pain/fever medicines.
  • Do not combine multiple pain medicines without advice, especially if you have kidney disease, liver disease, stomach ulcer, asthma, pregnancy, or take blood thinners.
  • Do not give adult medicines to children unless a qualified clinician advises it.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Severe symptoms, confusion, fainting, breathing difficulty, chest pain, severe dehydration, or sudden weakness need urgent medical care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider
Tests to discuss with doctor
  • Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
  • Relevant blood, urine, imaging, or specialist tests only after clinical assessment
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: Indication of Schirmer Test – Indications, Procedures, Results

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area from the RX Article Professional Blocks panel.

More from this topic
  1. Hemoglobin A1c Test

    The hemoglobin? A1c test—also known as glycated hemoglobin?, glycosylated hemoglobin, HbA1c, or simply A1c—is used to measure an individual’s glucose control levels. The test shows average blood sugar...

    November 6, 2025 • Rx Lab Test (A - Z)
  2. Orbital Decompression Surgery

    Orbital decompression is an operation to make more room inside the eye socket. The eye socket is called the “orbit.” It is a cone-shaped space made...

    August 18, 2025 • Rx Lab Test (A - Z)
  3. Olfactory Nerve Disorders

    Olfactory nerve disorders affect our sense of smell. This can impact our ability to enjoy food, detect danger like gas leaks, or even notice warning signs...

    May 8, 2024 • Rx Lab Test (A - Z)
  4. Biological Terrain Assessment (BTA)

    Biological Terrain Assessment (BTA) is a holistic approach to understanding the health of our bodies by examining various aspects of our biological terrain. In simpler terms,...

    December 15, 2023 • Rx Lab Test (A - Z)
  5. Ingrown Toenai – onychocryptosis or uunguisincarnatus

    Ingrown toenail, also known as onychocryptosis or uunguisincarnatus, is the most common nail problem encountered in both general practice and dermatology.[rx] An ingrown toenail occurs when the nail...

    July 8, 2022 • Rx Lab Test (A - Z)
  6. Physical Exam HEENT

    HEENT stands for “head, eyes, ears, nose, and throat.” If someone is experiencing symptoms that affect those areas, such as sneezing, congestion, and a sore throat,...

    May 6, 2022 • Rx Lab Test (A - Z)
  7. Thyroid Function Tests

    Thyroid? Function tests are used to tell if your thyroid? gland is functioning properly by measuring the number of thyroid hormones in your blood. They are...

    April 15, 2022 • Rx Lab Test (A - Z)
  8. Thyroid Gland Function Tests – Indications, Procedures, Results

    The TSH test and the T4 test are the two most common thyroid? function tests. The TSH test is often done first because it’s the best way...

    April 15, 2022 • Rx Lab Test (A - Z)
  9. TIBC Test

    A total iron-binding capacity (TIBC) test is a blood test to see if you have too much or too little iron in your blood measures the...

    April 15, 2022 • Rx Lab Test (A - Z)
  10. Shaded Surface Display (SSD) Test

    A shaded surface display (SSD) test (sometimes called feature-extraction or iso-surfacing) is a surface-rendered 3D image-producing system that provides a realistically looking three-dimensional view image of...

    April 9, 2022 • Rx Lab Test (A - Z)