Bawazeer Ahmed M, Hodge William G
University of Ottawa Eye Institute, Ottawa, Ontario, Canada.
Cornea. 2003 May;22(4):285-7. doi: 10.1097/00003226-200305000-00001.
The 5-minute Schirmer test is a commonly described test for dry eye syndrome but is impractical for most ophthalmologists to perform routinely because of the 5-minute time frame. Hence, we decided to evaluate the intraindividual reliability of different wetting times of the Schirmer basal tear secretion test correlated to that of the standard 5-minute Schirmer test.
A prospective study was performed using 60 eyes of 30 patients. All patients had symptoms of dry eye syndrome. Patients were excluded if they had anatomic lid abnormalities that could interfere with the conduct of the test. The reliability of the Schirmer test at 30 seconds and 1, 2, 3, and 4 minutes was compared with that of the standard 5-minute test using the intraclass correlation coefficient (ICC).
The ICC for each eye was only moderate at 30 seconds but was high to extremely high thereafter. Specifically, at 1 minute, the ICC for right eyes was 0.938 and for left eyes was 0.817. Furthermore, 100% of patients with severe dry eye (defined as a 5-minute Schirmer test of 5.5 mm or less) had a 1-minute Schirmer test less than or equal to 2 mm. Also, 80% of patients with a moderate dry eye (defined as a 5-minute Schirmer test between 5.5 to 10 mm) had a 1-minute test between 3 to 6 mm.
Our results support the hypothesis that shorter durations of the 5-minute Schirmer test correlate highly with those of the 5-minute test. Specifically, the 1-minute test correlates highly with the 5-minute test and will make this test much more practical for ophthalmologists.
5分钟泪液分泌试验是常用于检测干眼综合征的一项检查，但由于需时5分钟，大多数眼科医生难以常规开展。因此，我们决定评估与标准5分钟泪液分泌试验相关的不同湿润时间的Schirmer基础泪液分泌试验的个体内可靠性。
对30例患者的60只眼进行前瞻性研究。所有患者均有干眼综合征症状。若患者存在可能干扰检查进行的眼睑解剖异常，则将其排除。使用组内相关系数（ICC）将30秒、1分钟、2分钟、3分钟和4分钟时的Schirmer试验的可靠性与标准5分钟试验的可靠性进行比较。
每只眼在30秒时的ICC仅为中等，但此后为高至极高。具体而言，在1分钟时，右眼的ICC为0.938，左眼的ICC为0.817。此外，重度干眼患者（定义为5分钟泪液分泌试验≤5.5 mm）中100%的患者1分钟泪液分泌试验≤2 mm。而且，中度干眼患者（定义为5分钟泪液分泌试验在5.5至10 mm之间）中80%的患者1分钟试验结果在3至6 mm之间。
我们的结果支持这样的假设，即5分钟泪液分泌试验的较短时间与5分钟试验的结果高度相关。具体而言，1分钟试验与5分钟试验高度相关，这将使该检查对眼科医生而言更加实用。
