A 45 y.o. female comes to the office with a chief complaint of tearing ou and foreign body sensation. On exam, of note are small superficial punctate epitheliopathy diffusely over the central cornea. Her tear film is scanty ou. One would expect her Schirmer’s test with anesthetic to show:

  1. >15mm with anesthetic
  2. < 10mm with anesthetic
  3. >20mm without anesthetic
  4. < 5mm without anesthetic

Correct Answer: < 10mm with anesthetic

Schirmer’s Test is a test of tear production and is useful in diagnosis of dry eye syndrome. Normally, tear production should be at least 10-15mm after application of a topical anesthetic. Without anesthetic, increased tear production is expected to account for any foreign body sensation induced by the strips. In a patient with dry eyes, one would expect less than 10mm of tear production with anesthetic after 5 minutes.

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