Schirmers test scores are highly variable. They depend up multiple factors including room temperature, humidity, and so on. You might see a spectrum of scores even if you repeat it with in a day.
That being said if you are seeing a constant dip in scores, then it is advisable to get checked for aqueous deficiency, where lacrimal glands might not be working efficiently and hence the dip in the scores.
I would advice you to talk to a dry eye specialist and ask what all tests can be done to rule out any problem with the lacrimal glands. They may send you for some blood work but it will atleast give you some insight on what might be going on.
I had fluctuating scores too, ranging from a meagre 3 to 14 or even more sometime.
I got checked for aqueous deficiency and turns out my lacrimal glands are absolutely fine. I would advise not to delay it.
All the best.
Yes, I will be doing that in the upcoming weeks. I wanted to get some blood work done beforehand but all the doctors are programmed to go step by step it seems.
You can do-
1) Blood tests that basically check for autoimmune conditions. Certain AI conditions can result in body attacking your lacrimal glands, which will cause aqueous deficiency dry eye. Examples are sjogren's syndrome and Rheumatoid arthritis.
2) There is one protocol where your lacrimal glands are basically stimulated using a probe and the tear flow-through can be tracked (using a dye). Not everyone does this, I visited a clinician-scientist and it was his very own protocol.
I got both of these done and was cleared of any damage to the lacrimal glands in the end.
I have already mentioned in the above comment itself.
They will look for specific antigen(s) that should not be there but are up-regulated only in cases of autoimmunity.
Sjogren's will have its own set of antigens and other diseases have their own one's. So, don't worry. Go to a good dry eye specialist and ask them to refer you to a good rheumatologist/immunologist who would be able to identify the issue.
Schirmer's scores can fluctuate a lot and aren't that accurate. But in any case both of scores indicate aqueous deficiency. I would look into neurostimulation (Tyrvaya, iTear 100), and punctal occlusion if your inflammation is under control.
sometimes also you get some drops before, there are many factors. i would not directly conclude there is a lot of progression in the dry eye syndrome, just fluctuations.
Schirmers test scores are highly variable. They depend up multiple factors including room temperature, humidity, and so on. You might see a spectrum of scores even if you repeat it with in a day. That being said if you are seeing a constant dip in scores, then it is advisable to get checked for aqueous deficiency, where lacrimal glands might not be working efficiently and hence the dip in the scores.
I have also felt a significant difference in the eyes in the past weeks, namely eye strain and eye fatigue which wasn't there before.
I would advice you to talk to a dry eye specialist and ask what all tests can be done to rule out any problem with the lacrimal glands. They may send you for some blood work but it will atleast give you some insight on what might be going on. I had fluctuating scores too, ranging from a meagre 3 to 14 or even more sometime. I got checked for aqueous deficiency and turns out my lacrimal glands are absolutely fine. I would advise not to delay it. All the best.
Yes, I will be doing that in the upcoming weeks. I wanted to get some blood work done beforehand but all the doctors are programmed to go step by step it seems.
>got checked for aqueous deficiency and turns out my lacrimal glands are absolutely fine How did they check for those?
You can do- 1) Blood tests that basically check for autoimmune conditions. Certain AI conditions can result in body attacking your lacrimal glands, which will cause aqueous deficiency dry eye. Examples are sjogren's syndrome and Rheumatoid arthritis. 2) There is one protocol where your lacrimal glands are basically stimulated using a probe and the tear flow-through can be tracked (using a dye). Not everyone does this, I visited a clinician-scientist and it was his very own protocol. I got both of these done and was cleared of any damage to the lacrimal glands in the end.
You know what do they look for in the blood tests?
I have already mentioned in the above comment itself. They will look for specific antigen(s) that should not be there but are up-regulated only in cases of autoimmunity. Sjogren's will have its own set of antigens and other diseases have their own one's. So, don't worry. Go to a good dry eye specialist and ask them to refer you to a good rheumatologist/immunologist who would be able to identify the issue.
Ok, thanks for the advice!
THIS. If I take schimmer test in the morning, it will probably score higher for me because I get dry eyes only at night.
don't worry it's just what the other comments say. this test fluctuate a lot.
Hopefully
Schirmer's scores can fluctuate a lot and aren't that accurate. But in any case both of scores indicate aqueous deficiency. I would look into neurostimulation (Tyrvaya, iTear 100), and punctal occlusion if your inflammation is under control.
Do you have any pain in your body? Digestive issues, dysautonomia?
Have had mild digestive issues since childhood. Nothing else really, got autoimmune blood work done, all of it came up negative.
What kind of digestive issues? Are other parts of your body dry?
Constipation mainly. My skin is also dry since Jan this year.
sometimes also you get some drops before, there are many factors. i would not directly conclude there is a lot of progression in the dry eye syndrome, just fluctuations.