Name of the Procedure:

Ophthalmic Mucous Membrane Tests

• Commonly known as: Ocular Surface Tests, Lacrimal Function Tests
• Technical terms: Schirmer Test, Tear Break-Up Time (TBUT)

Summary

Ophthalmic mucous membrane tests are a series of assessments conducted to evaluate the health and function of the eye's tear film and mucous membranes. These tests help in diagnosing conditions that affect tear production and the quality of the tear film on the eye's surface.

Purpose

• To diagnose dry eye syndrome and other tear film disorders.
• To assess the quality and quantity of tear production.
• To help determine the underlying causes of ocular surface discomfort.

Indications

• Patients experiencing symptoms such as eye dryness, irritation, burning, or a sensation of grittiness.
• Candidates with conditions like Sjögren's syndrome, blepharitis, or contact lens discomfort.
• Anyone reporting fluctuating visual clarity or excessive tearing.

Preparation

• Patients are usually advised to discontinue the use of certain eye medications or contact lenses before the test.
• No specific fasting or significant medical preparation is generally required.
• A comprehensive eye examination may be conducted beforehand.

Procedure Description

1. Schirmer Test:
   • A small strip of filter paper is placed inside the lower eyelid of each eye.
   • The patient closes their eyes for 5 minutes.
   • The wetting length of the paper is measured to assess tear production.
2. Tear Break-Up Time (TBUT):
   • A fluorescein dye is applied to the eye.
   • After blinking, the eye is examined under a slit lamp microscope to observe how long it takes for dry spots to appear on the corneal surface after blinking.

Tools:

• Schirmer test strips, fluorescein dye, slit lamp microscope.

Anesthesia:

• None typically required, though anesthetic drops can be used for comfort.

Duration

• Each test takes approximately 5-10 minutes.

Setting

• The procedure is usually performed in an ophthalmologist's office or a specialized eye clinic.

Personnel

• Conducted by ophthalmologists or optometrists.
• Assisted by trained ophthalmic technicians or nurses.

Risks and Complications

• Mild discomfort or a foreign body sensation during the tests.
• Rare instances of allergic reactions to fluorescein dye.
• Temporary increase in tear production or slight irritation.

Benefits

• Accurate diagnosis of tear film disorders.
• Helps tailor the appropriate treatment plan for managing symptoms and improving eye health.
• Quick and relatively non-invasive.

Recovery

• Minimal post-procedure care is needed.
• Normal activities can usually be resumed immediately after the tests.
• Any short-term discomfort can often be managed with lubricating eye drops.

Alternatives

• For patients who are unable to undergo these tests:
  • Non-invasive tear breakup time (NIBUT) using specialized devices.
  • Osmolarity tests to measure tear film salt concentration.
• Pros and cons:
  • Alternatives may be costlier or require advanced equipment but can provide more detailed analysis.

Patient Experience

• Patients may experience a brief sensation of irritation or tearing during the tests.
• The procedures are generally well-tolerated, and any discomfort typically subsides shortly afterward.
• Comfort measures include using lubricating eye drops post-procedure if needed.