Which dry eye tests do I need to ask to be done by optician (UK)?

[FoggyMoggy]

Hi all

I did touch on this in another post but thought it might be better to start a new post as I have an eye test on Thursday. In my last post which got onto this subject one of you mentioned a Shirmer Test ( I may not have spelt it right) and another said there were 3 tests and it tends to be rheumies who do the Shirmer Test.

I would love to be armed with some info anyway when I go for my eye test and whether they will only you test you if they see you have dry eyes, or whether you can ask for further tests (and whether these are on the NHS or private).

Many thanks

[Hidden]

Hi! I have had a schirmer test done by my optometrist. It is pretty painless - well, only a little. They put a special strip of thin paper in each eye and leave it in for a few minutes, take it out and somehow read it and it shows how little moisture is made available in each eye. They should know what they are doing, but opt not to have an anaesthetic drop in your eyes, as I have been informed this may give a slightly false reading. Look that one up maybe. Mine hurt a little as they took the paper out, as my eyes were very dry and sore. Oh, and don't use any eye drops for at least 24-hr before the schirmer test, as that can give a false reading also. All these little things that shouldn't hurt, but will. My Dr told me would only believe a schirmer test done by an optometrist - so that's what I did - and guess what? She still does not believe I have it - imagination or old age!!! You should be permitted to kill some people.

[FoggyMoggy in reply to Hidden]

Hi Hidden many thanks for that! Did you just ask your optometrist to do the test or does the GP have to suggest it? Once they said I had dry eyes (not last time) and they just suggested drops and no Schirmer Test!

Oh wow, can't believe your GP didn't believe the results of your test!! Blimming heck!

[NikkyO]

Hi Foggymoggy,

I too am in the UK. I had the schirmer (I don't know how to spell it either!) test done about 8 weeks ago at Manchester Eye hospital, I was referred there by my rheumatologist. I did find it very uncomfortable but then the test revealed severe dry eyes. My eye balls are bone dry with no tear film at all, my glands are all blocked and tear production is extremely low and of poor quality (no oils). The opthomologist inserted punctal plugs but they fell out within a couple of days. Saw her again last week and have been put on Ikervis eye drops this time. It's early days yet but they are meant to reduce inflammation and slow down the dry eye disease process. They only prescribe it if your dry eye is severe enough or if there is corneal damage. I also have hyloforte drops and visco tears on prescription which I don't know what I'd do without! Hope this helps, I don't profess to know much myself, there's soo much to learn! Good luck with the test! X

[FoggyMoggy in reply to NikkyO]

Hi NikkyO

Many thanks, it's always good to hear other people's experiences and learn from them. So you really needed to be referred to get the Schirmer Test and couldn't really ask for it yourself? I am having a routine eye test tomorrow but I don't suppose I can just ask for one to test my eyes. They usually tell me if they're dry and they didn't say they were last time but they were the time before. I won't use eye drops before going but unfortunately I'm on meds which 'dry me up' in general because I suffer with hyperhidrosis.

Good luck with your own eyes and hope the drops work before long! x

[NikkyO in reply to FoggyMoggy]

Yeah, you do need a referral, usually from a rheumatologist. Actually rheumy's do do the test as well but the day I saw the rheumy my eyes were too painful and she decided against it and said she'd leave that to the opthalmologist! You would need an initial referral from your GP to a rheumy, unless you are already seeing one? I had to put my hyloforte drops in about 20 mins before my appointment, I can't tolerate letting my eyes get too dry, the pain is too bad. In any case I've been told not to let them get dry coz I then run the risk of a cornea abrasion. It didnt make any difference with me they were still bone dry! Thanks foggy moggy, apparently it can take 3 to 6 months to feel any results from the ikervis so I'm going to have to be patient!

[Hidden in reply to NikkyO]

Hi again. I had the Schirmer test done as suggested by my Optometrist, and actually done by the Optometrist. I wasn't referred by anyone. She noticed how dry my eyes were while doing my usual annual eye test, and suggested it to provide proof or otherwise of Sjorgren's, as in her notes she saw that dry eye had been noted for several years, and gradually getting worse. (I know it was!!!) She suggested I came back the following week, without using the eye drops prior to the appointment, so that's what happened - and an instant result. I took her report to my GP who refused to believe it, after initially saying to me that this test is the best test to have. Have heard since then that the lip biopsy is the 'gold standard' for diagnosing SjS. They have a habit of shifting the goal posts, don't they? Is it just to make you have test after test do you think? Have all the other symptoms associated with SjS, have had for several years - and Drs don't want to believe either Fibromyalgia of Sjogren's. I have made up my mind - I know what I have and what I feel - they don't, and don't really give a fig.

PP

[FoggyMoggy in reply to Hidden]

Hidden I feel your frustration! I will be guided by my optometrist but yes I've heard the lip biopsy is the gold standard for Sjogrens too - but yes totally annoying the way they keep changing the goalposts. I have a diagnosis of Fibro (again it was me who pushed for it ten years ago) but I'd never heard of Sjogrens and many other things it could be at that time so I do want SjS ruled out and anything else.

[NikkyO in reply to Hidden]

Hi 2woombaGirl, sorry, I wasn't trying to discount anything you said, maybe it's just my optometrist that doesn't do the schirmer test! He did do the other tests though and did tell me I have dry eyes and that he suspected sjogren's but that to get an official diagnosis I'd have to go back to my GP and go from there! It quite a performance, isn't it to get anywhere and to get the help we so badly need. At least you've managed to get your schirmer test done via your optometrist, its a shame you've got an uncooperative GP, maybe you would have better luck with a different one. Hope you get the help you need soon x

[FoggyMoggy in reply to NikkyO]

Ooo, that sounded very painful NikkyO . Yes I'm on eating list to see a rheumy, at least I will be once I've had my latest bloods. 3-6 months is quite some time to wait for some noticeable difference. Hope it will be sooner rather than later

[NikkyO in reply to FoggyMoggy]

Thanks FoggyMoggy 😁, let us know how you get on today x

[FoggyMoggy in reply to NikkyO]

Thanks NikkyO , well the optometrist didn't think I had SjS as she said I'd know if I had dry eyes and mouth. I think she said they were a bit dry but she was talking mainly about my hyperhidrosis as she had a family member with it too and so was offering help and advice on that score which was helpful to me!

[NikkyO in reply to FoggyMoggy]

Oh that's good, hope you do manage to get help with the hyperhidrosis. Regarding your eyes being mildly dry, they don't have to be severely dry to have sjogren's, some people have it and don't present with eye symptoms. So it's still worth you having the blood tests and seeing a rheumatologist. X

[FoggyMoggy in reply to NikkyO]

Thanks NikkyO . Yes I'd heard you don't have to present with severely dry eyes for SjS and I did try and explain that. Take care x