COVID-19 (Coronavirus) Information

Your health and safety are our top priorities. Learn more about our COVID-19 evaluation and testing and our commitment to providing great care while maintaining the safest environment possible.

Health Library

Schirmer test

Schirmer test

Tear test; Tearing test; Dry eye test; Basal secretion test; Sjögren - Schirmer; Schirmer's test


The Schirmer test determines whether the eye produces enough tears to keep it moist.

How the Test is Performed


The eye doctor will place the end of a special paper strip inside the lower eyelid of each eye. Both eyes are tested at the same time. Before the test, you will be given numbing eye drops to prevent your eyes from tearing due to irritation from the paper strips.

The exact procedure may vary. Most often, the eyes are closed for 5 minutes. Close your eyes gently. Closing the eyes tightly or rubbing the eyes during the test can cause abnormal test results.

After 5 minutes, the doctor removes the paper and measures how much of it has become moist.

Sometimes the test is done without numbing drops to test for other types of tear problems.

The phenol red thread test is similar to the Schirmer test, except that red strips of special thread are used instead of paper strips. Numbing drops are not needed. The test takes 15 seconds.


How to Prepare for the Test


You will be asked to remove your glasses or contact lenses before the test.


How the Test will Feel


Some people find that holding the paper against the eye is irritating or mildly uncomfortable. The numbing drops often sting at first.


Why the Test is Performed


This test is used when the eye doctor suspects you have dry eye. Symptoms include dryness of the eyes or excessive watering of the eyes.


Normal Results


More than 10 mm of moisture on the filter paper after 5 minutes is a sign of normal tear production. Both eyes normally release the same amount of tears.


What Abnormal Results Mean


Dry eyes may result from:

  • Aging
  • Swelling or inflammation of the eyelids (blepharitis)
  • Climate changes
  • Corneal ulcers and infections
  • Eye infections (for example, conjunctivitis)
  • Laser vision correction
  • Leukemia
  • Lymphoma (cancer of the lymph system)
  • Rheumatoid arthritis
  • Previous eyelid or facial surgery
  • Sjögren syndrome
  • Vitamin A deficiency




There are no risks with this test.




DO NOT rub the eyes for at least 30 minutes after the test. Leave contact lenses out for at least 2 hours after the test.

Even though the Schirmer test has been available for more than 100 years, several studies show that it does not properly identify a large group of people with dry eye. Newer and better tests are being developed. One test measures a molecule called lactoferrin. People with low tear production and dry eye have low levels of this molecule.

Another test measures tear osmolarity, or how concentrated the tears are. The higher the osmolarity, the more likely it is that you have dry eye.




Akpek EK, Amescua G, Farid M, et al; American Academy of Ophthalmology Preferred Practice Pattern Cornea and External Disease Panel. Dry eye syndrome Preferred Practice Pattern. Ophthalmology. 2019;126(1):286-334. PMID: 30366798

Bohm KJ, Djalilian AR, Pflugfelder SC, Starr CE. Dry eye. In: Mannis MJ, Holland EJ, eds. Cornea: Fundamentals, Diagnosis and Management. 4th ed. Philadelphia, PA: Elsevier; 2017:chap 33.

Feder RS, Olsen TW, Prum BE Jr, et al. Comprehensive adult medical eye evaluation Preferred Practice Pattern guidelines. Ophthalmology. 2016;123(1):209-236. PMID: 26581558

BACK TO TOPText only

  • Eye



  • Schirmer's test

    Schirmer's test


    • Eye



    • Schirmer's test

      Schirmer's test


    A Closer Look


      Self Care


        Tests for Schirmer test


        Review Date: 2/28/2019

        Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

        The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.