One-Minute Schirmer Test for Basal Tear Secretion

Purpose: It takes 5 minutes for the standard Schirmer test and is time-consuming in clinic practice. The purpose of this study is to restore the time spending on this test. Methods: This was a prospective study. We collected 100 eyes of 50 patients, including dry eye groups and normal subjects. The wetting of Schirmer strips were recorded at 1, 2, 3, 4 and 5 minutes. The correlation of 1-, 2-, 3- and 4- minute test compared with the standard 5-minute test in the same group of patients and the reliability of this test were checked. The sensitivity and specificity was tested by ROC curve. Results: In 100 eyes of 50 patients, there were 31 severe dry eyes, 30 mild-moderate dry eyes, and 39 normal eyes. According to the ROC curve, if the results of 1-minute Schirmer test less than 3 mm were the criteria for the severe dry eye, the sensitivity was 0.935, and the specificity was 0.754. If the results of 2-minute Schirmer test less than 4 mm were the criteria for the severe dry eye, the sensitivity was 0.968, and the specificity was 0.826. The sensitivity and specificity at the 2-minute Schirmer test is higher than those in the 1-minute Schirmer test. Conclusion: This study showed that the 1-minute and 2-minute Schirmer test can be used to replace the 5-minute Schirmer test. It is suggested the cutoff points of 3mm at the 1-minute and 4 mm at the 2-minute Schirmer test can be used to diagnose the severe dry eyes.