|Year : 1988 | Volume
| Issue : 1 | Page : 15-16
Lacrimination in Sjogren's syndrome. Is Schirmer's test really a useful diagnostic tool?
DP Bhadoria, Anita Panda, KR Sundaram, AN Malaviya
Clinical Immunology Section, Deptt of Medicine, ALLMS., Ansari Nagar, New Delhi-110 029, India
D P Bhadoria
Clinical Immunology Section, Deptt of Medicine, ALLMS., Ansari Nagar, New Delhi-110 029
Source of Support: None, Conflict of Interest: None
In the past, Schinier's test was used as a diagnostic tool in Sjogren's Syndrome. In this study, a comparison of 100 normal patients with 2l patients with Sjogren's Syndrome has been made to study its reliability. It has been concluded that Schimer's test is of a poor diagnostic value in Sjogren's Syndrome.
|How to cite this article:|
Bhadoria D P, Panda A, Sundaram K R, Malaviya A N. Lacrimination in Sjogren's syndrome. Is Schirmer's test really a useful diagnostic tool?. Indian J Ophthalmol 1988;36:15-6
|How to cite this URL:|
Bhadoria D P, Panda A, Sundaram K R, Malaviya A N. Lacrimination in Sjogren's syndrome. Is Schirmer's test really a useful diagnostic tool?. Indian J Ophthalmol [serial online] 1988 [cited 2020 Apr 7];36:15-6. Available from: http://www.ijo.in/text.asp?1988/36/1/15/26171
| Introduction|| |
Due to lymphocyte-mediated destruction of exocrine glands the secretion of various mucosal glands including that of lacrimal glands decreases in patients with sicca complex (Sjogren s Syndrome)  In the past Schirmer's test has been used very frequently to identify the patients with Sjogreri s syndrome. In the present study, an attempt has been made to find out the feasibility of this test as a diagnostic tool.
| Material & Methods|| |
The first group consisted of 111 normal persons without any ocular problems with a median age of 40 (range 15-60) years. The second group consisted of 21 patients Sjogren's syndrome with a median age of 40 (range : 23-59) years. Schirmer's test (ST) was performed using a strip of Whatman No. 41 filter paper 5 x 3 5 mm, folded at right angle 5 mm from one end and inserted into the unanaesthetised conjunctival sac at the inner one third of the lower eye lid At the end of 5 minutes the strips were removed and the length moistened was measured starting at the fold.
| Observations & results|| |
[Table - 1] shows the frequency distribution of Schirmer's test it shows that the lacrimation in patients of Sjogreri s Syndrome is considerably reduced (P < 0.001) in comparision to normal persons. But as is apparent from [Table - 2] that if the probabilities of misclassification are balanced the best limit for separation of patients of Sjogren s Syndrome from normal population was 8.5 mm of filter paper strip. With this limit probability of misclassification of a person from control group would be 2 3.87% and that of patients of Sjogren s Syndrome 23.80% with sensitivity and specificity of "6.2% and 76.13% respectively.
| Discussion|| |
From the data presented it is clear that if 8.5 mm of filter paer wetting is used as the limit Schimef s Test would give high false positive and negative results. It would thus appear that Schimer's Test is a crude tool for discriminating between the normal and the diseased population. Thus the arbitrary limit often accepted as 10 .or 15 mm includes a large population of normal persons and seriously limits the value of this test Therefore, it cannot be utilised in diagnosing patients having Sjogreri s Syndrome ,.
| References|| |
Strand V. Talal, Bull. Rheum Dis, 30, 1046, 1980
Shearn MA, Sjogreri s Syndrome, Philadelphia, 1971.
Van Bijesterveld, Arch. Ophthalmol. 82, 10, 1969.
[Table - 1], [Table - 2]