Comparison Between Normal Values of 2- and 5-Minute Schirmer Test Without Anesthesia

Karampatakis, Vasileios; Karamitsos, Athanasios; Skriapa, Athanasia; Pastiadis, Georgios

doi:10.1097/ico.0b013e3181c2964c

Cited by 41 publications

(29 citation statements)

References 16 publications

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“…9,14 This has been attributed to the initial reflex tear secretion which is stimulated by the application of the filter paper strip, which decreases as sensory adaptation occurs, that is, the subject becomes accustomed to the presence of the Schirmer strip. The in vitro data indicate that there is a reduction in the rate of wetting over time, even in the absence of reflex tearing (Fig.…”

Section: Discussionmentioning

confidence: 98%

“…7,[9][10][11] Poor reproducibility is another commonly cited weakness when discussing the ST. 10,12,13 It is believed that the stimulation of reflex tearing by the filter paper causes a variation in the rate of wetting of the Schirmer strip. 9,12,14,15 An alternative method of Schirmer testing employs a topical anesthetic instilled on to the ocular surface before application of the filter paper strip. The anesthetic reduces the initial reflex tearing which is normally produced during the ST in an attempt to reduce the variability of the test, as well as decreases the level of discomfort for the patient.…”

mentioning

confidence: 99%

“…Clinicians often cite this discomfort as a disadvantage of using the ST in everyday practice. 9 Several strategies have been employed in an attempt to reduce this patient discomfort, including reducing the test duration from 5 minutes to 1 or 2 minutes. 7,[9][10][11] Poor reproducibility is another commonly cited weakness when discussing the ST. 10,12,13 It is believed that the stimulation of reflex tearing by the filter paper causes a variation in the rate of wetting of the Schirmer strip.…”

mentioning

confidence: 99%

“…9 Several strategies have been employed in an attempt to reduce this patient discomfort, including reducing the test duration from 5 minutes to 1 or 2 minutes. 7,[9][10][11] Poor reproducibility is another commonly cited weakness when discussing the ST. 10,12,13 It is believed that the stimulation of reflex tearing by the filter paper causes a variation in the rate of wetting of the Schirmer strip. 9,12,14,15 An alternative method of Schirmer testing employs a topical anesthetic instilled on to the ocular surface before application of the filter paper strip.…”

mentioning

confidence: 99%

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Effects of Humidity on Tests of Tear Production

Buckmaster

Pearce

2016

Cornea

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Patients with severe dry eye disease produce Schirmer test results which are unaffected by environmental humidity. However, patients with moderate Schirmer wetting lengths may be falsely diagnosed as having dry eye disease if their test is undertaken in a low-humidity environment. This phenomenon may be overcome with the use of plastic sheathing. Previous studies investigating the effects of environmental conditions on the tear film may have been affected by this phenomenon.

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Section: Discussionmentioning

confidence: 98%

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confidence: 99%

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confidence: 99%

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confidence: 99%

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Effects of Humidity on Tests of Tear Production

Buckmaster

Pearce

2016

Cornea

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“…Schirmer I (without anesthesia; Schirmer II is performed with anesthesia) consists of placing a filter paper strip on the lower lid margin in the temporal position of an unanesthetized patient 43. This continues to be a useful test for the clinician; however, the length of time required for the procedure is a disadvantage as it causes discomfort to the patient often resulting in reflex tearing which impacts the variability of the data.…”

Section: Challenges Of Measuring Osd In Glaucoma Patientsmentioning

confidence: 99%

Challenges in the clinical measurement of ocular surface disease in glaucoma patients

Pflugfelder¹,

Baudouin²

2011

OPTH

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Ocular surface disease (OSD) is common among glaucoma patients. Clinical assessment of OSD can be challenging. This review focuses on some of the limitations relating to both subjective and objective measures of OSD, including dry eye. A survey of the literature was conducted to identify the caveats associated with different methods of assessing OSD. The effect of preservatives on the ocular surface, with respect to glaucoma patients in particular, was also reviewed. Objective methods for assessing ocular surface health and disease include the Schirmer test, tear break-up time, fluorescein turnover, corneal and conjunctival staining, tear osmolarity, and vital dyes. These measures all have limitations in terms of their ability to grade the severity of OSD. Previous studies using the OSD Index showed a mild-to-moderate correlation to dry eye disease severity. Other scoring systems for dry eye have shown a relationship to patient symptom scores or quality of life. Due to the challenges clinicians face concerning both subjective and objective ocular surface health assessments, discerning clinical improvement in ocular surface disease can be a challenge. Further research is needed in order to optimize existing clinical methods and/or identify alternative techniques for assessing OSD in the glaucoma population.

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One Week Sustained In Vivo Therapeutic Release and Safety of Novel Extended‐Wear Silicone Hydrogel Contact Lenses

DiPasquale

Wuchte

Mosley

et al. 2021

Adv Healthcare Materials

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Since the seminal work of Wichterle in 1965 describing the first soft contact lenses and their potential for ocular drug delivery, the field has yet to realize his vision. Maintaining all lens commercial properties combined with a mechanism for controlled drug release of therapeutically relevant concentrations for duration of wear is a major challenge. Here, successful in vivo week-long sustained release of a small molecular weight therapeutic in rabbits from extended-wear silicone hydrogel contact lenses meeting all commercial specifications by utilizing a novel macromolecular memory strategy is reported for the first time. Lens-treated eyes show a continuous, therapeutically relevant bromfenac tear concentration of 256.4 ± 23.1 μg mL −1 for 8 days. Bromday (bromfenac ophthalmic solution, 0.09%, Bausch+Lomb) topical drops exhibit a quick peak concentration of 269.3 ± 85.7 μg mL −1 and 100 min duration. Bioavailability (AUC 0-8days ) and mean residence time of lenses are 26 and 155 times higher than drops, respectively. Lenses are safe, well tolerated, and no corneal histological differences are observed. This work highlights the enormous potential of drug releasing lenses as a platform strategy, and offers a new dropless clinical strategy for post-cataract, uveitis, post-LASIK, and corneal abrasion treatment.

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Comparison Between Normal Values of 2- and 5-Minute Schirmer Test Without Anesthesia

Cited by 41 publications

References 16 publications

Effects of Humidity on Tests of Tear Production

Effects of Humidity on Tests of Tear Production

Challenges in the clinical measurement of ocular surface disease in glaucoma patients

One Week Sustained In Vivo Therapeutic Release and Safety of Novel Extended‐Wear Silicone Hydrogel Contact Lenses

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