The role of the Schirmer's test and orbital morphology in predicting dry-eye syndrome after blepharoplasty.

The Schirmer's test for tear production has been recommended to identify patients with diminished tear production prior to blepharoplasty. The decision to operate may rest with this simple clinical test. This paper reports a prospective clinical evaluation of 100 consecutive blepharoplasty patients to determine the role of preoperative assessment of the orbital and periorbital morphology and the Schirmer's test in predicting the likelihood of the development of the dry-eye syndrome (DES) postoperatively. Our findings indicate that the morphology of the orbital region is a more important and reliable method of evaluating a predisposition to developing dry eyes postoperatively than is the Schirmer's test. The value of the Schirmer's test is to flag patients prior to blepharoplasty, but it should not be relied on as the sole method of screening patients and it is definitely of less importance than the history and physical examination.