Schirmer’s test reliably predicts dry eye outcomes
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Lower Schirmer’s test score correlated with increased corneal staining and more severe disease burden among patients with dry eye disease, according to research presented at the Association for Research in Vision and Ophthalmology meeting.
Jeffrey Gemi, MD, director of special projects, anterior segment, at Ora, told Ocular Surgery News that there are several diagnostic tools physicians can use to identify and analyze dry eye disease (DED). He and his colleagues specifically sought to determine how well Schirmer’s test can predict outcomes.
“Schirmer’s test has long been a hallmark diagnostic technique used by clinicians to determine the presence of dry eye in patients,” Gemi said. “With that being said, how well does Schirmer’s test identify dry eye, and how well does Schirmer’s test analyze for severity of disease in these patients when compared to other clinical outcomes?”
Researchers analyzed data from 1,149 patients (mean age 57.4 years, 70% women) who underwent screening before any kind of therapeutic intervention. Patients were separated into normal (greater than 10 mm), borderline DED (between 6 mm and 10 mm) and severe DED (5 mm or less) groups based on results from unanesthetized Schirmer’s tests.
Total and regional corneal fluorescein staining (CFS), Ocular Surface Disease Index score, disease duration and age were compared among the three groups. Only data from patients’ right eyes were included.
Schirmer’s scores correlated with total CFS (P < .0001), and CFS was progressively worse in those with lower Schirmer’s scores. Total CFS was 9.2 ± 2.4 in the severe group and 8.9 ± 2.4 in the borderline group compared with 7.4 ± 2.7 in the normal group (both P < .0001).
The results were consistent for all five subregional staining analyses. Inferior CFS was 2.1 ± 0.6 in the severe group, 2 ± 0.6 in the borderline group and 1.8 ± 0.7 in the normal group (both P < .0001).
Schirmer’s score was correlated with age (P = .0001). Patients in the severe group (mean age 61.1 years) were older than those in the normal group (mean age 54.7 years, P < .0001). Patients in the severe group also had longer DED duration (mean 11.5 years) than patients in the normal group (mean 9.8 years, P = .02).
“What we found is that patients who have worse Schirmer’s scores — meaning less than 5 mm on the test — also have a more severe disease burden, also have increased corneal staining, typically are older and typically share a longer duration of burden of disease,” Gemi said. “What this tells us is that Schirmer’s score can accurately capture dry eye disease intensity as it relates to other clinical outcomes. We can use Schirmer’s score reliably to predict how patients will ultimately stain and also predict the longevity of disease among patients.”
- References:
- Gemi J. VIDEO: Schirmer’s test comparable to other tools when capturing dry eye intensity. www.healio.com/news/ophthalmology/20210504/video-schirmers-test-comparable-to-other-tools-when-capturing-dry-eye-intensity. Published May 4, 2021. Accessed June 21, 2021.
- For more information:
- Jeffrey Gemi, MD, can be reached at Ora Inc., 300 Brickstone Square, Andover, MA 01810; email: jgemi@oraclinical.com.
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