Alternate Names: Tear test; Tearing test

How Performed: The exact procedure may vary somewhat. Both eyes are tested at the same time. Most often, this test consists of placing a small strip of filter paper inside the lower eyelid (conjunctival sac). The eyes are closed for 5 minutes. The paper is then removed and examined for moisture. Sometimes a topical anesthetic in instilled into the eye before placement of the filter paper; this inhibits tearing that occurs because of irritation from the paper and ensures that only the basic level of tear production is measured. The tears may also be examined for their content of lysozyme, an enzyme normally found in tears.

Fluorescein eye drops contain a dye that is placed in the eye. The dye should drain with the tears through the lacrimal duct into the nose. The dye should be cleared from the eyes and found in the nose within 2 minutes.

How To Prepare: Remove contact lenses before the test.

Infants and children:
The physical and psychological preparation you can provide for this or any test or procedure depends on your child’s age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child’s age:

• infant test or procedure preparation (birth to 1 year)
• toddler test or procedure preparation (1 to 3 years)
• preschooler test or procedure preparation (3 to 6 years)
• schoolage test or procedure preparation (6 to 12 years)
• adolescent test or procedure preparation (12 to 18 years)

How It Feels: Some people find that holding the paper against the eye is irritating or mildly uncomfortable.

Risks: Essentially, there are no risks.

Why Performed: This test is used when a person experiences very dry eyes or excessive watering of the eyes.

Normal Values: A negative (more than 10 mm of moisture on the filter paper in 5 minutes) test result is normal.
Both eyes normally secrete the same amount of tears.

Abnormal Results: Dry eyes can occur from conditions such as:

• aging
• dehydration
• corneal ulcers and infections
• eye infections (for example conjunctivitis)
• vitamin A deficiency
• Sjogren syndrome
• secondary tearing deficiency (associated with disorders such as - lymphoma, leukemia, and rheumatoid arthritis)

• some eye infections
• blockage of the lacrimal duct

Cost:

Special Considerations: This test indicates the amount of tear production and/or ability to drain tears into the nose. It is not specific as an indicator of the cause of tearing difficulties such as dry eye.

Close the eyes gently during the test. Tight closing of the eyes or rubbing the eyes during the test can cause abnormal test results.

Do not rub the eyes for at least 30 minutes after the test. Contact lenses should be left out for at least 2 hours after the test.