The Effect of Nasal Mucosal Stimulation on Schirmer Tests in Sjögren’s Syndrome and Dry Eye Patients

Maximal tear secretion evoked by controlled stimulation of corneal sensory nerves in healthy individuals and dry eye subjects

“…Measuring the secretory capacity of the lacrimal glands in patients with eye surface disorders provides important information to assess the severity of glandular damage in these ocular pathologies where tear dynamics are compromised, of which SS is a prominent example [22,39,40]. Different stimulation procedures have been tested to induce a near-maximal reflex secretion by the tear glands, including mechanical stimulation of the nose mucosa with a cotton-tip applicator [6,22,41], or exposure of the eye surface to chemical irritants like citric acid [42] or onion lachrymatory factor [43]. A common limitation of these methods is that they cause significant irritation and discomfort to the patient, and the intensity and duration of the stimulus applied is not controlled.…”