Factors Affecting Tear Health

  • Anjali Prashar


If tears are collected in a glass tube and observed with the naked eye, what we see is just an uncomplicated clear liquid. It is difficult to digest the level of complexity these drops offer. Even more unconceivable is how these few drops in the ocean of a body are affected by factors that are often in our control and seldom beyond. This chapter discusses how tear chemistry is affected by age, diet, surgery, medication etc.

References: Author’s Tears

  1. Acera A, Vecino E, Duran JA (2013) Tear MMP-9 levels as a marker of ocular surface inflammation in conjunctivochalasis. Invest Ophthalmol Vis Sci 54:8285–8291PubMedCrossRefGoogle Scholar
  2. Aho VV, Paavilainen V, Nevalainen TJ, Peuravuori H, Saari KM (2003a) Diurnal variation in group IIa phospholipase A2 content in tears of contact lens wearers and normal controls. Graefes Arch Clin Exp Ophthalmol 241:85–88PubMedCrossRefGoogle Scholar
  3. Aho VV, Holopainen JM, Tervo T, Moilanen JA et al (2003b) Group IIA phospholipase A(2) content in tears of patients having photorefractive keratectomy. J Cataract Refract Surg 29:2163–2167PubMedCrossRefGoogle Scholar
  4. Alevi D, Perry HD, Wedel A, Rosenberg E et al (2017) Effect of sleep position on the ocular surface. Cornea 36:567–571PubMedCrossRefGoogle Scholar
  5. Ananthi S, Santhosh RS, Nila MV, Prajna NV et al (2011) Comparative proteomics of human male and female tears by two-dimensional electrophoresis. Exp Eye Res 92:454–463PubMedCrossRefGoogle Scholar
  6. Baca JT, Taormina CR, Feingold E, Finegold DN et al (2007b) Mass spectral determination of fasting tear glucose concentrations in nondiabetic volunteers. Clin Chem 53:1370–1372CrossRefGoogle Scholar
  7. Badamchian M, Damavandy AA, Damavandy H, Wadhwa SD et al (2007) Identification and quantification of thymosin beta4 in human saliva and tears. Ann N Y Acad Sci 1112:458–465PubMedCrossRefPubMedCentralGoogle Scholar
  8. Bae SH, Shin YJ, Kim HK, Hyon JY et al (2016) Vitamin D supplementation for patients with dry eye syndrome refractory to conventional treatment. Sci Rep 6:33083PubMedPubMedCentralCrossRefGoogle Scholar
  9. Bagheri A, Najmi H, Salim RE, Yazdani S (2015) Tear condition following unilateral ptosis surgery. Orbit 34:66–71PubMedCrossRefGoogle Scholar
  10. Baker GR, Morton M, Rajapaska RS, Bullock M et al (2006) Altered tear composition in smokers and patients with graves ophthalmopathy. Arch Ophthalmol 124:1451–1456PubMedCrossRefPubMedCentralGoogle Scholar
  11. Bakhurji S, Yassin SA, Abdulhameed RM (2018) A healthy infant with bloody tears: case report and mini-review of the literature. Saudi J Ophthalmol 32:246–249PubMedCrossRefPubMedCentralGoogle Scholar
  12. Balasubramanian SA, Pye DC, Willcox MD (2012a) Levels of lactoferrin, secretory IgA and serum albumin in the tear film of people with keratoconus. Exp Eye Res 96:132–137PubMedCrossRefGoogle Scholar
  13. Balasubramanian SA, Pye DC, Willcox MD (2013a) Effects of eye rubbing on the levels of protease, protease activity and cytokines in tears: relevance in keratoconus. Clin Exp Optom 96:214–218PubMedCrossRefGoogle Scholar
  14. Battat L, Macri A, Dursun D, Pflugfelder SC (2001) Effects of laser in situ keratomileusis on tear production, clearance, and the ocular surface. Ophthalmology 108:1230–1235PubMedCrossRefPubMedCentralGoogle Scholar
  15. Beden U, Turgut-Coban D, Aygun C, Ulu-Gungor I et al (2008) Tear secretion and ferning patterns among premature and full-term newborns. Turk J Pediatr 50:155–159PubMedPubMedCentralGoogle Scholar
  16. Benito MJ, Gonzalez-Garcia MJ, Teson M, Garcia N et al (2014) Intra- and inter-day variation of cytokines and chemokines in tears of healthy subjects. Exp Eye Res 120:43–49PubMedCrossRefPubMedCentralGoogle Scholar
  17. Benlloch-Navarro S, Franco I, Sanchez-Vallejo V, Silvestre D et al (2013) Lipid peroxidation is increased in tears from the elderly. Exp Eye Res 115:199–205PubMedCrossRefPubMedCentralGoogle Scholar
  18. Bitton E, Keech A, Jones L, Simpson T (2008) Subjective and objective variation of the tear film pre- and post-sleep. Optom Vis Sci 85:740–749PubMedCrossRefGoogle Scholar
  19. Borderie VM, Gineys R, Goldschmidt P, Batellier L et al (2012) Association of anti-herpes simplex virus IgG in tears and serum with clinical presentation in patients with presumed herpetic simplex keratitis. Cornea 31:1251–1256PubMedCrossRefGoogle Scholar
  20. Butrus SI, Ochsner KI, Abelson MB, Schwartz LB (1990) The level of tryptase in human tears. An indicator of activation of conjunctival mast cells. Ophthalmology 97:1678–1683PubMedCrossRefGoogle Scholar
  21. Byun YS, Lee HJ, Shin S, Chung SH (2017) Elevation of autophagy markers in Sjogren syndrome dry eye. Sci Rep 7:17280PubMedPubMedCentralCrossRefGoogle Scholar
  22. Caffery BE (1991) Influence of diet on tear function. Optom Vis Sci 68:58–72PubMedCrossRefGoogle Scholar
  23. Carney LG (1991) Considerations in contact lens use under adverse conditions: proceedings of a symposium. The National Academies Press, Washington, DCGoogle Scholar
  24. Carney LG, Hill RM (1976) Human tear pH. Diurnal variations. Arch Ophthalmol 94:821–824PubMedCrossRefGoogle Scholar
  25. Carracedo G, Carpena C, Concepcion P, Diaz V et al (2017) Presence of melatonin in human tears. J Optom 10:3–4PubMedCrossRefGoogle Scholar
  26. Chong RS, Jiang YZ, Boey PY, Yu SJ et al (2010) Tear cytokine profile in medicated glaucoma patients: effect of monocyte chemoattractant protein 1 on early posttrabeculectomy outcome. Ophthalmology 117:2353–2358PubMedCrossRefPubMedCentralGoogle Scholar
  27. Choy CK, Benzie IF, Cho P (2000) Ascorbic acid concentration and total antioxidant activity of human tear fluid measured using the FRASC assay. Invest Ophthalmol Vis Sci 41:3293–3298PubMedPubMedCentralGoogle Scholar
  28. Choy C, Benzie I, Cho P (2003) Antioxidants in tears and plasma: Inter-relationships and effect of vitamin C supplementation. Curr Eye Res 27:55–60PubMedCrossRefPubMedCentralGoogle Scholar
  29. Claustrat B, Leston J (2015) Melatonin: physiological effects in humans. Neurochirurgie 61:77–84PubMedCrossRefPubMedCentralGoogle Scholar
  30. Coles WH, Jaros PA (1984) Dynamics of ocular surface pH. Br J Ophthalmol 68:549–552PubMedPubMedCentralCrossRefGoogle Scholar
  31. Colligris B, Alkozi HA, Pintor J (2014) Recent developments on dry eye disease treatment compounds. Saudi J Ophthalmol 28:19–30PubMedCrossRefGoogle Scholar
  32. Cortes M, Esposito G, Sacco R, Gillet VB et al (2018) NGF and iNOS changes in tears from video display terminal workers. Curr Eye Res 43:1119–1125PubMedCrossRefGoogle Scholar
  33. Cumurcu T, Gunduz A, Cumurcu BE, Gul IG et al (2013) The changes in tear film parameters and impression cytology in heavily drinking men. Cornea 32:237–241PubMedCrossRefPubMedCentralGoogle Scholar
  34. da Silva CM, de Sousa RA, Baptista AM (2013) Assessment of tear amount in subjects under the effect of (inhaled) cocaine. J Psychoactive Drugs 45:195–198PubMedCrossRefPubMedCentralGoogle Scholar
  35. Daniel E, Duriasamy M, Ebenezer GJ, Shobhana, Job CK (2004) Elevated free tear lactoferrin levels in leprosy are associated with Type 2 reactions. Indian J Ophthalmol 52:51–56PubMedGoogle Scholar
  36. Deai T, Fukuda M, Tomoda Y, Higaki S et al (2004) Excimer laser photokeratectomy reactivates latent herpes simplex virus. Jpn J Ophthalmol 48:570–572PubMedCrossRefPubMedCentralGoogle Scholar
  37. Deinema LA, Vingrys AJ, Wong CY, Jackson DC et al (2017) A randomized, double-masked, placebo-controlled clinical trial of two forms of omega-3 supplements for treating dry eye disease. Ophthalmology 124:43–52PubMedCrossRefPubMedCentralGoogle Scholar
  38. Demirci G, Karaman Erdur S, Ozsutcu M, Eliacik M et al (2018) Dry eye assessment in patients with vitamin D deficiency. Eye Contact Lens 44(Suppl 1):S62–S65PubMedPubMedCentralGoogle Scholar
  39. Dogru M, Kojima T, Matsumoto Y, Ibrahim O et al (2010) The early effects of alcohol consumption on tear functions and ocular surface. Invest Ophthalmol Vis Sci 51:6257Google Scholar
  40. Downie LE, Gad A, Wong CY, Gray JHV et al (2018) Modulating contact lens discomfort with anti-inflammatory approaches: a randomized controlled trial. Invest Ophthalmol Vis Sci 59:3755–3766PubMedCrossRefPubMedCentralGoogle Scholar
  41. Dutta S, Islam MN, Chakroborty S, Mondal A et al (2014) Effect of anti-oxidant on tear film in patients suffering from diabetes mellitus. J Indian Med Assoc 112:108–109PubMedPubMedCentralGoogle Scholar
  42. Enriquez-de-Salamanca A, Castellanos E, Stern ME, Fernandez I et al (2010) Tear cytokine and chemokine analysis and clinical correlations in evaporative-type dry eye disease. Mol Vis 16:862–873PubMedPubMedCentralGoogle Scholar
  43. Epitropoulos AT, Donnenfeld ED, Shah ZA, Holland EJ et al (2016) Effect of oral re-esterified omega-3 nutritional supplementation on dry eyes. Cornea 35:1185–1191PubMedPubMedCentralCrossRefGoogle Scholar
  44. Esmaeelpour M, Watts PO, Boulton ME, Cai J, Murphy PJ (2011) Tear film volume and protein analysis in full-term newborn infants. Cornea 30:400–404PubMedPubMedCentralCrossRefGoogle Scholar
  45. Esmaeli B (2005) Management of excessive tearing as a side effect of docetaxel. Clin Breast Cancer 5:455–457PubMedCrossRefPubMedCentralGoogle Scholar
  46. Esmaeli B, Ahmadi MA, Rivera E, Valero V et al (2002) Docetaxel secretion in tears: association with lacrimal drainage obstruction. Arch Ophthalmol 120:1180–1182PubMedCrossRefPubMedCentralGoogle Scholar
  47. Fariselli C, Giannaccare G, Fresina M, Versura P (2018) Trehalose/hyaluronate eyedrop effects on ocular surface inflammatory markers and mucin expression in dry eye patients. Clin Ophthalmol 12:1293–1300PubMedPubMedCentralCrossRefGoogle Scholar
  48. Fenga C, Aragona P, Cacciola A, Spinella R et al (2008) Meibomian gland dysfunction and ocular discomfort in video display terminal workers. Eye (Lond) 22:91–95CrossRefGoogle Scholar
  49. Flanagan JL, Willcox MD (2009) Role of lactoferrin in the tear film. Biochimie 91:35–43PubMedCrossRefGoogle Scholar
  50. Fukuda M, Fullard RJ, Willcox MD, Baleriola-Lucas C et al (1996) Fibronectin in the tear film. Invest Ophthalmol Vis Sci 37:459–467PubMedPubMedCentralGoogle Scholar
  51. Fullard RJ, Snyder C (1990) Protein levels in nonstimulated and stimulated tears of normal human subjects. Invest Ophthalmol Vis Sci 31:1119–1126PubMedPubMedCentralGoogle Scholar
  52. Fust A, Veres A, Kiszel P, Nagy ZZ et al (2003) Changes in tear protein pattern after photorefractive keratectomy. Eur J Ophthalmol 13:525–531PubMedCrossRefGoogle Scholar
  53. Galbis-Estrada C, Pinazo-Duran MD, Martinez-Castillo S, Morales JM et al (2015) A metabolomic approach to dry eye disorders. The role of oral supplements with antioxidants and omega 3 fatty acids. Mol Vis 21:555–567PubMedPubMedCentralGoogle Scholar
  54. Gauba V, Curtis ZJ (2014) Sleep position and the ocular surface in a high airflow environment. Saudi J Ophthalmol 28:66–68PubMedCrossRefPubMedCentralGoogle Scholar
  55. Gaudana R, Ananthula HK, Parenky A, Mitra AK (2010) Ocular drug delivery. AAPS J 12:348–360PubMedPubMedCentralCrossRefGoogle Scholar
  56. Gayton JL (2009) Etiology, prevalence, and treatment of dry eye disease. Clin Ophthalmol 3:405–412PubMedPubMedCentralCrossRefGoogle Scholar
  57. Girard B, Piaton JM, Keller P, Nguyen TH (2018) Botulinum neurotoxin A injection for the treatment of epiphora with patent lacrymal ducts. J Fr Ophtalmol 41:343–349PubMedCrossRefPubMedCentralGoogle Scholar
  58. Glasgow BJ, Gasymov OK (2011) Focus on molecules: tear lipocalin. Exp Eye Res 92:242–243PubMedCrossRefPubMedCentralGoogle Scholar
  59. Grube M, Holler E, Weber D, Holler B et al (2016) Risk factors and outcome of chronic graft-versus-host disease after allogeneic stem cell transplantation-results from a single-center observational study. Biol Blood Marrow Transplant 22:1781–1791PubMedCrossRefGoogle Scholar
  60. Grumetto L, Cennamo G, Del Prete A, La Rotonda MI, Barbato F (2002) Pharmacokinetics of cetirizine in tear fluid after a single oral dose. Clin Pharmacokinet 41:525–531PubMedCrossRefGoogle Scholar
  61. Guillon M, Maissa C (2010) Tear film evaporation – effect of age and gender. Cont Lens Anterior Eye 33:171–175PubMedCrossRefPubMedCentralGoogle Scholar
  62. Hirayama M, Murat D, Liu Y, Kojima T et al (2013) Efficacy of a novel moist cool air device in office workers with dry eye disease. Acta Ophthalmol 91:756–762PubMedCrossRefPubMedCentralGoogle Scholar
  63. Holopainen JM, Moilanen JA, Sorsa T, Kivela-Rajamaki M et al (2003) Activation of matrix metalloproteinase-8 by membrane type 1-MMP and their expression in human tears after photorefractive keratectomy. Invest Ophthalmol Vis Sci 44:2550–2556PubMedCrossRefPubMedCentralGoogle Scholar
  64. Horwitz BL, Christensen GR, Ritzmann SR (1978) Diurnal profiles of tear lysozyme and gamma A globulin. Ann Ophthalmol 10:75–80PubMedPubMedCentralGoogle Scholar
  65. Huth SW, Miller MJ, Leopold IH (1981) Calcium and protein in tears: diurnal variation. Arch Ophthalmol 99:1628–1633PubMedCrossRefGoogle Scholar
  66. Idu FK, Emina MO, Ubaru CO (2013) Tear secretion and tear stability of women on hormonal contraceptives. J Optom 6:45–50CrossRefGoogle Scholar
  67. Jensen OL, Gluud BS, Eriksen HO (1985a) Fibronectin in tears following surgical trauma to the eye. Acta Ophthalmol (Copenh) 63:346–350CrossRefGoogle Scholar
  68. Jensen OL, Gluud BS, Eriksen HO, Birgens HS (1985b) In: Peeters H (ed) Protides of the biological fluids. Elsevier, Amsterdam, pp 157–160Google Scholar
  69. Jung JW, Han SJ, Nam SM, Kim TI et al (2016) Meibomian gland dysfunction and tear cytokines after cataract surgery according to preoperative meibomian gland status. Clin Exp Ophthalmol 44:555–562PubMedCrossRefPubMedCentralGoogle Scholar
  70. Kangari H, Eftekhari MH, Sardari S, Hashemi H et al (2013) Short-term consumption of oral omega-3 and dry eye syndrome. Ophthalmology 120:2191–2196PubMedCrossRefGoogle Scholar
  71. Karamitsos A, Kokkas V, Goulas A, Paraskevopoulos P et al (2013) Ocular surface and tear film abnormalities in women under adjuvant chemotherapy for breast cancer with the 5-Fluorouracil, Epirubicin and Cyclophosphamide (FEC) regimen. Hippokratia 17:120–125PubMedPubMedCentralGoogle Scholar
  72. Kawai S, Nakajima T, Hokari S, Komoda T, Kawai K (2002) Apolipoprotein A-I concentration in tears in diabetic retinopathy. Ann Clin Biochem 39:56–61PubMedCrossRefGoogle Scholar
  73. Kerimoglu H, Ozturk B, Gunduz K, Bozkurt B et al (2010) Effect of altered eating habits and periods during Ramadan fasting on intraocular pressure, tear secretion, corneal and anterior chamber parameters. Eye (Lond) 24:97–100CrossRefGoogle Scholar
  74. Khalil HE, Aboud S, Azzab M (2018) Comparative study between smokers and nonsmokers regarding dry eye. Delta J Ophthalmol 19:9–13CrossRefGoogle Scholar
  75. Kim JH, Kim JH, Nam WH, Yi K et al (2012) Oral alcohol administration disturbs tear film and ocular surface. Ophthalmology 119:965–971PubMedCrossRefPubMedCentralGoogle Scholar
  76. Kim N, Kim JW, Baek JH, Kim JS et al (2018) S-1-induced lacrimal drainage obstruction and its association with ingredients/metabolites of S-1 in tears and plasma: a prospective multi-institutional study. Cancer Res Treat 50:30–39PubMedCrossRefPubMedCentralGoogle Scholar
  77. Kishazi E, Dor M, Eperon S, Oberic A et al (2018) Differential profiling of lacrimal cytokines in patients suffering from thyroid-associated orbitopathy. Sci Rep 8:10792PubMedPubMedCentralCrossRefGoogle Scholar
  78. Kumar R, Parmar IP, Chhillar N, Lal H (1997) Tear lactoferrin concentration during postoperative ocular inflammation in cataract surgery. Acta Ophthalmol Scand 75:142–144PubMedCrossRefPubMedCentralGoogle Scholar
  79. Kurtul BE, Ozer PA, Aydinli MS (2015) The association of vitamin D deficiency with tear break-up time and Schirmer testing in non-Sjogren dry eye. Eye (Lond) 29:1081–1084CrossRefGoogle Scholar
  80. Kyrmizakis DE, Pangalos A, Papadakis CE, Logothetis J et al (2004) The use of botulinum toxin type A in the treatment of Frey and crocodile tears syndromes. J Oral Maxillofac Surg 62:840–844PubMedCrossRefPubMedCentralGoogle Scholar
  81. Lam SM, Tong L, Reux B, Duan X et al (2014b) Lipidomic analysis of human tear fluid reveals structure-specific lipid alterations in dry eye syndrome. J Lipid Res 55:299–306PubMedPubMedCentralCrossRefGoogle Scholar
  82. Lam-Franco L, Perfecto-Avalos Y, Patino-Ramirez BE, Rodriguez Garcia A (2018) IL-1alpha and MMP-9 tear levels of patients with active ocular rosacea before and after treatment with systemic azithromycin or doxycycline. Ophthalmic Res 60:109–114PubMedCrossRefPubMedCentralGoogle Scholar
  83. Lane JD, Krumholz DM, Sack RA, Morris C (2006) Tear glucose dynamics in diabetes mellitus. Curr Eye Res 31:895–901PubMedCrossRefPubMedCentralGoogle Scholar
  84. Lee JB, Ryu CH, Kim J, Kim EK, Kim HB (2000) Comparison of tear secretion and tear film instability after photorefractive keratectomy and laser in situ keratomileusis. J Cataract Refract Surg 26:1326–1331PubMedCrossRefPubMedCentralGoogle Scholar
  85. Lee YB, Koh JW, Hyon JY, Wee WR et al (2014) Sleep deprivation reduces tear secretion and impairs the tear film. Invest Ophthalmol Vis Sci 55:3525–3531PubMedCrossRefGoogle Scholar
  86. Leonardi A, Abelson MB (2003) Double-masked, randomized, placebo-controlled clinical study of the mast cell-stabilizing effects of treatment with olopatadine in the conjunctival allergen challenge model in humans. Clin Ther 25:2539–2552PubMedCrossRefPubMedCentralGoogle Scholar
  87. Lifshitz M, Weinstein O, Gavrilov V, Rosenthal G, Lifshitz T (1999) Acetaminophen (paracetamol) levels in human tears. Ther Drug Monit 21:544–546PubMedCrossRefPubMedCentralGoogle Scholar
  88. Liu J, Shi B, He S, Yao X et al (2010a) Changes to tear cytokines of type 2 diabetic patients with or without retinopathy. Mol Vis 16:2931–2938PubMedPubMedCentralGoogle Scholar
  89. Liu Q, Liu J, Ren C, Cai W et al (2017) Proteomic analysis of tears following acupuncture treatment for menopausal dry eye disease by two-dimensional nano-liquid chromatography coupled with tandem mass spectrometry. Int J Nanomedicine 12:1663–1671PubMedPubMedCentralCrossRefGoogle Scholar
  90. Lopez-Miguel A, Teson M, Martin-Montanez V, Enriquez-de-Salamanca A et al (2014) Dry eye exacerbation in patients exposed to desiccating stress under controlled environmental conditions. Am J Ophthalmol 157:788–798 e782PubMedCrossRefPubMedCentralGoogle Scholar
  91. Lopez-Miguel A, Teson M, Martin-Montanez V, Enriquez-de-Salamanca A et al (2016) Clinical and molecular inflammatory response in sjogren syndrome-associated dry eye patients under desiccating stress. Am J Ophthalmol 161:133–141. e131-132PubMedCrossRefPubMedCentralGoogle Scholar
  92. Loprinzi CL, Love RR, Garrity JA, Ames MM (1990) Cyclophosphamide, methotrexate, and 5-fluorouracil (CMF)-induced ocular toxicity. Cancer Invest 8:459–465PubMedCrossRefPubMedCentralGoogle Scholar
  93. Luevano-Contreras C, Chapman-Novakofski K (2010) Dietary advanced glycation end products and aging. Nutrients 2:1247–1265PubMedPubMedCentralCrossRefGoogle Scholar
  94. Madej KA (2010) Analysis of meconium, nails and tears for determination of medicines and drugs of abuse. Trends Analy Chem 29:246–259CrossRefGoogle Scholar
  95. Makateb A, Torabifard H (2017) Dry eye signs and symptoms in night-time workers. J Curr Ophthalmol 29:270–273PubMedPubMedCentralCrossRefGoogle Scholar
  96. Mantelli F, Lambiase A, Sacchetti M, Orlandi V et al (2015) Cocaine snorting may induce ocular surface damage through corneal sensitivity impairment. Graefes Arch Clin Exp Ophthalmol 253:765–772PubMedCrossRefGoogle Scholar
  97. Markoulli M, Papas E, Cole N, Holden BA (2012) The diurnal variation of matrix metalloproteinase-9 and its associated factors in human tears. Invest Ophthalmol Vis Sci 53:1479–1484PubMedCrossRefPubMedCentralGoogle Scholar
  98. Martin-Montanez V, Enriquez-de-Salamanca A, Lopez-de la Rosa A, Lopez-Miguel A et al (2016) Effect of environmental conditions on the concentration of tear inflammatory mediators during contact lens wear. Cornea 35:1192–1198PubMedCrossRefPubMedCentralGoogle Scholar
  99. Masmali AM, Al-Bahlal JM, El-Hiti GA, Akhtar S et al (2015b) Repeatability and diurnal variation of tear ferning test. Eye Contact Lens 41:262–267PubMedCrossRefPubMedCentralGoogle Scholar
  100. Masmali AM, Al-Shehri A, Alanazi SA, Abusharaha A et al (2016) Assessment of tear film quality among smokers using tear ferning patterns. J Ophthalmol 2016:8154315PubMedPubMedCentralCrossRefGoogle Scholar
  101. Matsumoto Y, Dogru M, Goto E, Sasaki Y et al (2008) Alterations of the tear film and ocular surface health in chronic smokers. Eye (Lond) 22:961–968CrossRefGoogle Scholar
  102. McDermott AM (2004) Defensins and other antimicrobial peptides at the ocular surface. Ocul Surf 2:229–247PubMedPubMedCentralCrossRefGoogle Scholar
  103. McGill JI, Liakos GM, Goulding N, Seal DV (1984) Normal tear protein profiles and age-related changes. Br J Ophthalmol 68:316–320PubMedPubMedCentralCrossRefGoogle Scholar
  104. McMurray DN, Rey H, Casazza LJ, Watson RR (1977) Effect of moderate malnutrition on concentrations of immunoglobulins and enzymes in tears and saliva of young Colombian children. Am J Clin Nutr 30:1944–1948PubMedCrossRefPubMedCentralGoogle Scholar
  105. Megwas WA, Izuawuba MA (2008) The effect of acetaminophen (Paracetamol) on tear production. J Nigerian Opt Assoc 14:27–29Google Scholar
  106. Micera A, Di Zazzo A, Esposito G, Longo R et al (2018) Age-related changes to human tear composition. Invest Ophthalmol Vis Sci 59:2024–2031PubMedCrossRefPubMedCentralGoogle Scholar
  107. Monaco F, Piredda S, Mutani R, Mastropaolo C, Tondi M (1982) The free fraction of valproic acid in tears, saliva, and cerebrospinal fluid. Epilepsia 23:23–26PubMedCrossRefPubMedCentralGoogle Scholar
  108. Mora P, Ceglarek U, Manzotti F, Zavota L et al (2008) Cyclosporin A in the ocular fluids of uveitis patients following long-term systemic administration. Graefes Arch Clin Exp Ophthalmol 246:1047–1052PubMedCrossRefPubMedCentralGoogle Scholar
  109. Murube J (2008) REM sleep: tear secretion and dreams. Ocul Surf 6:2–8PubMedCrossRefPubMedCentralGoogle Scholar
  110. Nair S, Vanathi M, Mahapatra M, Seth T et al (2018) Tear inflammatory mediators and protein in eyes of post allogenic hematopoeitic stem cell transplant patients. Ocul Surf 16:352–367PubMedCrossRefPubMedCentralGoogle Scholar
  111. Nejima R, Miyata K, Tanabe T, Okamoto F et al (2005) Corneal barrier function, tear film stability, and corneal sensation after photorefractive keratectomy and laser in situ keratomileusis. Am J Ophthalmol 139:64–71PubMedCrossRefPubMedCentralGoogle Scholar
  112. Norn M (1985) The effects of drugs on tear flow. Trans Ophthalmol Soc U K 104(Pt 4):410–414PubMedPubMedCentralGoogle Scholar
  113. Osei KA, Ovenseri-Ogbomo G, Kyei S, Ntodie M (2014) The effect of caffeine on tear secretion. Optom Vis Sci 91:171–177PubMedGoogle Scholar
  114. Otto CS, McMann MA, Parmley VC, Dahlhauser KF et al (2002) Warm balanced salt solution for clearing tear film precipitation during cataract surgery. J Cataract Refract Surg 28:1318–1319PubMedCrossRefGoogle Scholar
  115. Patel S, Perez-Santonja JJ, Alio JL, Murphy PJ (2001) Corneal sensitivity and some properties of the tear film after laser in situ keratomileusis. J Refract Surg 17:17–24PubMedPubMedCentralGoogle Scholar
  116. Peponis V, Papathanasiou M, Kapranou A, Magkou C et al (2002) Protective role of oral antioxidant supplementation in ocular surface of diabetic patients. Br J Ophthalmol 86:1369–1373PubMedPubMedCentralCrossRefGoogle Scholar
  117. Pinazo-Duran MD, Galbis-Estrada C, Pons-Vazquez S, Cantu-Dibildox J et al (2013) Effects of a nutraceutical formulation based on the combination of antioxidants and omega-3 essential fatty acids in the expression of inflammation and immune response mediators in tears from patients with dry eye disorders. Clin Interv Aging 8:139–148PubMedPubMedCentralCrossRefGoogle Scholar
  118. Postnikoff CK, Nichols KK (2017) Neutrophil and T-cell homeostasis in the closed eye. Invest Ophthalmol Vis Sci 58:6212–6220PubMedPubMedCentralCrossRefGoogle Scholar
  119. Postnikoff CK, Huisingh C, McGwin G, Nichols KK (2018) Leukocyte distribution in the open eye tears of normal and dry eye subjects. Curr Eye Res 43(10):1253–1259PubMedCrossRefGoogle Scholar
  120. Puinhas A, Sampaio P, Castanheira EM, Real Oliveira ME, Lira M (2013) Comparison of IgA, TNF-alpha and surface tension of the tear film in two different times of the day. Cont Lens Anterior Eye 36:140–145PubMedCrossRefGoogle Scholar
  121. Raines DA, Yusuf A, Jabak MH, Ahmed WS et al (1998) Simultaneous high-performance liquid chromatography analysis of azithromycin and two of its metabolites in human tears and plasma. Ther Drug Monit 20:680–684PubMedCrossRefGoogle Scholar
  122. Rees LW, Munn AD, Maddock J, Robinson PR (2000) The rapid determination of tobramycin in microlitre quantities of human tear fluid using LC-MS-MS. Chromatographia 52:S98–S100CrossRefGoogle Scholar
  123. Resan M, Stanojevic I, Petkovic A, Pajic B, Vojvodic D (2015) Levels of interleukin-6 in tears before and after excimer laser treatment. Vojnosanit Pregl 72:350–355PubMedCrossRefPubMedCentralGoogle Scholar
  124. Riemens A, Stoyanova E, Rothova A, Kuiper J (2012) Cytokines in tear fluid of patients with ocular graft-versus-host disease after allogeneic stem cell transplantation. Mol Vis 18:797–802PubMedPubMedCentralGoogle Scholar
  125. Rocha EM, Alves M, Rios JD, Dartt DA (2008) The aging lacrimal gland: changes in structure and function. Ocul Surf 6:162–174PubMedPubMedCentralCrossRefGoogle Scholar
  126. Rohit A, Willcox M, Stapleton F (2013a) Tear lipid layer and contact lens comfort: a review. Eye Contact Lens 39:247–253PubMedCrossRefPubMedCentralGoogle Scholar
  127. Rummenie VT, Matsumoto Y, Dogru M, Wang Y et al (2008) Tear cytokine and ocular surface alterations following brief passive cigarette smoke exposure. Cytokine 43:200–208PubMedCrossRefGoogle Scholar
  128. Runstrom G, Mann A, Tighe B (2013) The fall and rise of tear albumin levels: a multifactorial phenomenon. Ocul Surf 11:165–180PubMedCrossRefGoogle Scholar
  129. Rusciano D, Pezzino S, Olivieri M, Cristaldi M et al (2018) Age-related dry eye lactoferrin and lactobionic acid. Ophthalmic Res 60:1–6CrossRefGoogle Scholar
  130. Saari KM, Aine E, Posz A, Klockars M (1983) Lysozyme content of tears in normal subjects and in patients with external eye infections. Graefes Arch Clin Exp Ophthalmol 221:86–88PubMedCrossRefPubMedCentralGoogle Scholar
  131. Saari KM, Aho V, Paavilainen V, Nevalainen TJ (2001) Group II PLA(2) content of tears in normal subjects. Invest Ophthalmol Vis Sci 42:318–320PubMedPubMedCentralGoogle Scholar
  132. Sack RA, Tan KO, Tan A (1992) Diurnal tear cycle: evidence for a nocturnal inflammatory constitutive tear fluid. Invest Ophthalmol Vis Sci 33:626–640PubMedPubMedCentralGoogle Scholar
  133. Sand BB, Jensen OL, Eriksen JS, Vinding T (1986) Lysozyme in tears during post-operative inflammation of the eye. Acta Ophthalmol (Copenh) 64:504–508CrossRefGoogle Scholar
  134. Sano K, Kawashima M, Ikeura K, Arita R, Tsubota K (2015) Abdominal breathing increases tear secretion in healthy women. Ocul Surf 13:82–87PubMedCrossRefPubMedCentralGoogle Scholar
  135. Sariri R, Arasteh A, Mahmoodian J (2006) Heavy smoking and tears protein pattern. Asian J Chem 18:8–14Google Scholar
  136. Sariri R, Varasteh A, Sajedi RH (2010) Effect of Ramadan fasting on tear proteins. Acta Medica (Hradec Kralove) 53:147–151CrossRefGoogle Scholar
  137. Satici A, Bitiren M, Ozardali I, Vural H et al (2003) The effects of chronic smoking on the ocular surface and tear characteristics: a clinical, histological and biochemical study. Acta Ophthalmol Scand 81:583–587PubMedCrossRefPubMedCentralGoogle Scholar
  138. Sayin N, Kara N, Pekel G, Altinkaynak H (2014) Effects of chronic smoking on central corneal thickness, endothelial cell, and dry eye parameters. Cutan Ocul Toxicol 33:201–205PubMedCrossRefPubMedCentralGoogle Scholar
  139. Scuderi G, Contestabile MT, Gagliano C, Iacovello D et al (2012) Effects of phytoestrogen supplementation in postmenopausal women with dry eye syndrome: a randomized clinical trial. Can J Ophthalmol 47:489–492PubMedCrossRefPubMedCentralGoogle Scholar
  140. Service, R. F., These smart contacts can monitor the glucose in tears. Science 2018Google Scholar
  141. Semeraro F, Costagliola C, Cancarini A, Gilberti E et al (2012) Defining reference values of trace elements in the tear film: diagnostic methods and possible applications. Ecotoxicol Environ Saf 80:190–194CrossRefGoogle Scholar
  142. Sharanjeet-Kaur, Ho CY, Mutalib HA, Ghazali AR (2016) The relationship between tear ferning patterns and non-invasive tear break-up time in normal Asian population. J Optom 9:175–181CrossRefPubMedPubMedCentralGoogle Scholar
  143. Shetty R, Ghosh A, Lim RR, Subramani M et al (2015) Elevated expression of matrix metalloproteinase-9 and inflammatory cytokines in keratoconus patients is inhibited by cyclosporine A. Invest Ophthalmol Vis Sci 56:738–750PubMedCrossRefPubMedCentralGoogle Scholar
  144. Shigeyasu C, Yamada M, Akune Y (2016) Influence of ophthalmic solutions on tear components. Cornea 35(Suppl 1):S71–S77PubMedCrossRefPubMedCentralGoogle Scholar
  145. Shimazaki J, Shimmura S, Fujishima H, Tsubota K (2000) Association of preoperative tear function with surgical outcome in severe Stevens-Johnson syndrome. Ophthalmology 107:1518–1523PubMedCrossRefPubMedCentralGoogle Scholar
  146. Shoji J, Aso H, Inada N (2017) Clinical Usefulness of Simultaneous Measurement of the Tear Levels of CCL17, CCL24, and IL-16 for the Biomarkers of Allergic Conjunctival Disorders. Curr Eye Res 42:677–684PubMedCrossRefPubMedCentralGoogle Scholar
  147. Siganos DS, Popescu CN, Siganos CS, Pistola G (2000) Tear secretion following spherical and astigmatic excimer laser photorefractive keratectomy. J Cataract Refract Surg 26:1585–1589PubMedCrossRefPubMedCentralGoogle Scholar
  148. Singh AK, Nagpal S, Tyagi R (2018) A study of tear ferning patterns in elderly individuals with dry eye disorder. J Clin Diagn Res 12:NC01–NC04Google Scholar
  149. Su SB, Lu CW, Sheen JW, Kuo SC, Guo HR (2006) Tear secretion dysfunction among women workers engaged in light-on tests in the TFT-LCD industry. BMC Public Health 6:303PubMedPubMedCentralCrossRefGoogle Scholar
  150. Tabbara KF (2001) Tear tryptase in vernal keratoconjunctivitis. Arch Ophthalmol 119:338–342PubMedCrossRefGoogle Scholar
  151. Tan KO, Sack RA, Holden BA, Swarbrick HA (1993) Temporal sequence of changes in tear film composition during sleep. Curr Eye Res 12:1001–1007PubMedCrossRefGoogle Scholar
  152. Tauste A, Ronda E, Baste V, Bratveit M et al (2018) Ocular surface and tear film status among contact lens wearers and non-wearers who use VDT at work: comparing three different lens types. Int Arch Occup Environ Health 91:327–335PubMedCrossRefGoogle Scholar
  153. Teson M, Gonzalez-Garcia MJ, Lopez-Miguel A, Enriquez-de-Salamanca A et al (2013) Influence of a controlled environment simulating an in-flight airplane cabin on dry eye disease. Invest Ophthalmol Vis Sci 54:2093–2099PubMedCrossRefGoogle Scholar
  154. Thakur A, Willcox MD, Stapleton F (1998) The proinflammatory cytokines and arachidonic acid metabolites in human overnight tears: homeostatic mechanisms. J Clin Immunol 18:61–70PubMedCrossRefGoogle Scholar
  155. Thomas J, Jacob GP, Abraham L, Noushad B (2012) The effect of smoking on the ocular surface and the precorneal tear film. Australas Med J 5:221–226PubMedPubMedCentralCrossRefGoogle Scholar
  156. Tomlinson A, Cedarstaff TH (1992) Diurnal variation in human tear evaporation. J Br Contact Lens Assoc 15:77–79CrossRefGoogle Scholar
  157. Tomlinson A, Giesbrecht C (1994) Effect of age on human tear film evaporation in normals. Adv Exp Med Biol 350:271–274PubMedCrossRefGoogle Scholar
  158. Tomlinson A, Pearce EI, Simmons PA, Blades K (2001) Effect of oral contraceptives on tear physiology. Ophthalmic Physiol Opt 21:9–16PubMedCrossRefGoogle Scholar
  159. Tong L, Htoon HM, Hou A, Acharya RU et al (2018) Acupuncture and herbal formulation compared with artificial tears alone: evaluation of dry eye symptoms and associated tests in randomised clinical trial. BMJ Open Ophthalmol 3:e000150PubMedPubMedCentralCrossRefGoogle Scholar
  160. Tsalic M, Gilboa M, Visel B, Miller B, Haim N (2006) Epiphora (excessive tearing) and other ocular manifestations related to weekly docetaxel: underestimated dose-limiting toxicity. Med Oncol 23:57–61PubMedCrossRefPubMedCentralGoogle Scholar
  161. Uchino E, Sonoda S, Kinukawa N, Sakamoto T (2006) Alteration pattern of tear cytokines during the course of a day: diurnal rhythm analyzed by multicytokine assay. Cytokine 33:36–40PubMedCrossRefPubMedCentralGoogle Scholar
  162. Uchino Y, Uchino M, Yokoi N, Dogru M et al (2014) Alteration of tear mucin 5AC in office workers using visual display terminals: the Osaka Study. JAMA Ophthalmol 132:985–992PubMedCrossRefPubMedCentralGoogle Scholar
  163. Uchino Y, Uchino M, Yokoi N, Dogru M et al (2016) Impact of cigarette smoking on tear function and correlation between conjunctival goblet cells and tear MUC5AC concentration in office workers. Sci Rep 6:27699PubMedPubMedCentralCrossRefGoogle Scholar
  164. Valentic JP, Leopold IH, Dea FJ (1980) Excretion of salicylic acid into tears following oral administration of aspirin. Ophthalmology 87:815–820PubMedCrossRefGoogle Scholar
  165. Van Haeringen NJ (1997) Aging and the lacrimal system. Br J Ophthalmol 81:824–826PubMedCrossRefPubMedCentralGoogle Scholar
  166. Vardhan P, Dhiman KS (2014) Clinical study to assess the efficacy of Keshanjana and Netra Parisheka in the management of Shushkakshipaka (dry eye syndrome). Ayu 35:277–282PubMedPubMedCentralCrossRefGoogle Scholar
  167. Versura P, Bavelloni A, Grillini M, Fresina M, Campos EC (2013a) Diagnostic performance of a tear protein panel in early dry eye. Mol Vis 19:1247–1257PubMedPubMedCentralGoogle Scholar
  168. Versura P, Piazzi M, Giannaccare G, Fresina M et al (2016) 8th international conference on the tear film & ocular surface: basic science and clinical relevance, Montpellier, France, p 119Google Scholar
  169. Virtanen T, Ylatupa S, Mertaniemi P, Partanen P et al (1995) Tear fluid cellular fibronectin levels after photorefractive keratectomy. J Refract Surg 11:106–112PubMedPubMedCentralGoogle Scholar
  170. Ward SK, Dogru M, Wakamatsu T, Ibrahim O et al (2010) Passive cigarette smoke exposure and soft contact lens wear. Optom Vis Sci 87:367–372PubMedPubMedCentralGoogle Scholar
  171. Watson RR, McMurray DN, Martin P, Reyes MA (1985) Effect of age, malnutrition and renutrition on free secretory component and IgA in secretions. Am J Clin Nutr 42:281–288PubMedCrossRefPubMedCentralGoogle Scholar
  172. Weaver J (2011) Women’s tears contain chemical cues. Nat News.
  173. Wei Y, Gadaria-Rathod N, Epstein S, Asbell P (2013) Tear cytokine profile as a noninvasive biomarker of inflammation for ocular surface diseases: standard operating procedures. Invest Ophthalmol Vis Sci 54:8327–8336PubMedPubMedCentralCrossRefGoogle Scholar
  174. Willcox MD, Morris CA, Thakur A, Sack RA et al (1997) Complement and complement regulatory proteins in human tears. Invest Ophthalmol Vis Sci 38:1–8PubMedPubMedCentralGoogle Scholar
  175. Wong TT, Zhou L, Li J, Tong L et al (2011) Proteomic profiling of inflammatory signaling molecules in the tears of patients on chronic glaucoma medication. Invest Ophthalmol Vis Sci 52:7385–7391PubMedCrossRefGoogle Scholar
  176. Yang L, Yang Z, Yu H, Song H (2015) Acupuncture therapy is more effective than artificial tears for dry eye syndrome: evidence based on a meta-analysis. Evid Based Complement Alternat Med 2015:143858PubMedPubMedCentralGoogle Scholar
  177. Yildirim P, Garip Y, Karci AA, Guler T (2016) Dry eye in vitamin D deficiency: more than an incidental association. Int J Rheum Dis 19:49–54PubMedCrossRefPubMedCentralGoogle Scholar
  178. You YS, Qu NB, Yu XN (2016b) Alcohol consumption and dry eye syndrome: a meta-analysis. Int J Ophthalmol 9:1487–1492PubMedPubMedCentralGoogle Scholar
  179. Zhao Z, Liu J, Shi B, He S et al (2010) Advanced glycation end product (AGE) modified proteins in tears of diabetic patients. Mol Vis 16:1576–1584PubMedPubMedCentralGoogle Scholar
  180. Zhou L, Huang LQ, Beuerman RW, Grigg ME et al (2004) Proteomic analysis of human tears: defensin expression after ocular surface surgery. J Proteome Res 3:410–416PubMedCrossRefGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Anjali Prashar
    • 1
  1. 1.MumbaiIndia

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