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To the Editor.—
Decreased lacrimation is not usually regarded as a feature of amyotrophic lateral sclerosis. In the course of treating ten such patients over the last two years, decreased lacrimation as measured by the Schirmer test was observed. Since this is a devastating disease of unknown etiology, it is to be hoped that decreased lacrimation will be confirmed by others and explored as a new lead.The Schirmer tear test is performed by placing the tip of a strip of filter paper on the conjunctiva of the lower lid at the juncture of the outer and middle third of the lid. The patient closes his eyes lightly and after five minutes the length of filter paper wet by tears is recorded. Less than 15 mm of wetting is regarded as evidence of decreased tear production. Normal eyes can wet the entire 35-mm length in less than five minutes.
Copperman R. Decreased Lacrimation in Amyotrophic Lateral Sclerosis. JAMA. 1974;230(4):536. doi:10.1001/jama.1974.03240040014005
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