When realizing this test, the practitioner is testing the eyelid margin.A Schirmers test can measure the amount of moisture bathing the eye. This test is useful for determining the severity of the condition. A five-minute Schirmers test with and without anesthesia using a Whatman #41 filter paper 5 mm wide by 35 mm long is performed. For this test, wetting under 5 mm with or without anesthesia is considered diagnostic for dry eyes.If the results for the Schirmers test are abnormal, a Schirmer II test can be performed to measure reflex secretion. In this test, the nasal mucosa is irritated with a cotton-tipped applicator, after which tear production is measured with a Whatman #41 filter paper. For this test, wetting under 15 mm after five minutes is considered abnormal.A tear breakup time (TBUT) test measures the time it takes for tears to break up in the eye. The tear breakup time can be determined after placing a drop of fluorescein in the cul-de-sac.A tear protein analysis test measures the lysozyme contained within tears. In tears, lysozyme accounts for approximately 20 to 40 percent of total protein content.A lactoferrin analysis test provides good correlation with other tests.The presence of the recently described molecule Ap4A, naturally occurring in tears, is abnormally high in different states of ocular dryness. This molecule can be quantified biochemically simply by taking a tear sample with a plain Schirmer test.
Tolnaftate (INN) is a synthetic thiocarbamate used as an anti-fungal agent that may be sold  without medical prescription in most jurisdictions. It is supplied as a cream, powder, spray, liquid, and liquid aerosol. Tolnaftate is used to treat fungal conditions such as jock itch, athletes foot and ringworm. Mechanism
Although the exact mechanism of action is not entirely known, it is believed to inhibit squalene epoxidase, an important enzyme in the biosynthetic pathway of ergosterol (a key component of the fungal cell membrane) in a similar way to terbinafine. Uses
Tolnaftate has been found to be generally slightly less effective than azoles when used to treat tinea pedis (athletes foot). It is, however, useful when dealing with ringworm, especially when passed from pets to humans. Side effects
Side effects that may occur include:
allergic reactions like:
skin rash
itching or hives
swelling of the face, lips, or tongue
inflammation, redness, or pain at the affected areaLess severe side effects include:
dry skin
mild skin irritation, burning, or itching at the affected area

See also
Liranaftate, a similar thiocarbamate antifungal

References
External links
Medlines entry for tolnaftate