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The Tear Film: Anatomy and Physiology

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Ocular Fluid Dynamics

Abstract

This chapter explores the normal structure and function of the tear film. Normal properties and composition of tears as well as the structure of the aqueous, mucin, and meibomian layers are discussed. The role of supporting structures such as the eyelids, meibomian glands, and goblet cells in the lacrimal functional unit (LFU) is also reviewed. Finally, the physiologic roles of the tear film, including lubrication and nutrition of the ocular surface, visual function, anti-inflammatory and healing properties, and its role in ocular surface nerve modulation are all examined.

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References

  1. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). The ocular surface. 2007;5(2):75–92.

    Google Scholar 

  2. Tiffany JM. The normal tear film. Dev Ophthalmol. 2008;41:1–20.

    Google Scholar 

  3. Rolando M, Zierhut M. The ocular surface and tear film and their dysfunction in dry eye disease. Surv Ophthalmol. 2001;45 Suppl 2:S203–210.

    Article  Google Scholar 

  4. Willcox MDP, Argueso P, Georgiev GA, et al. TFOS DEWS II Tear Film Report. The ocular surface. 2017;15(3):366–403.

    Article  Google Scholar 

  5. Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the International Dry Eye WorkShop (2007). The ocular surface. 2007;5(2):108–152.

    Google Scholar 

  6. Gipson IK. The ocular surface: the challenge to enable and protect vision: the Friedenwald lecture. Invest Ophthalmol Vis Sci. 2007;48(10):4390; 4391–4398.

    Article  Google Scholar 

  7. Bron AJ, Tiffany JM, Gouveia SM, Yokoi N, Voon LW. Functional aspects of the tear film lipid layer. Exp Eye Res. 2004;78(3):347–360.

    Article  Google Scholar 

  8. Tiffany JM. Tears in health and disease. Eye (London, England). 2003;17(8):923–926.

    Article  Google Scholar 

  9. Zhao H, Jumblatt JE, Wood TO, Jumblatt MM. Quantification of MUC5AC protein in human tears. Cornea. 2001;20(8):873–877.

    Article  Google Scholar 

  10. Iwata S. Chemical composition of the aqueous phase. International ophthalmology clinics. 1973;13(1):29–46.

    Article  Google Scholar 

  11. Berman ER. Tears. In: Blakemore C, ed. Biochemistry of the Eye New York Springer Science+Business Media; 1991:63–84.

    Google Scholar 

  12. Ubels JL, Williams KK, Lopez Bernal D, Edelhauser HF. Evaluation of effects of a physiologic artificial tear on the corneal epithelial barrier: electrical resistance and carboxyfluorescein permeability. Advances in experimental medicine and biology. 1994;350:441–452.

    Google Scholar 

  13. Ohashi Y, Dogru M, Tsubota K. Laboratory findings in tear fluid analysis. Clin Chim Acta. 2006;369(1):17–28.

    Article  Google Scholar 

  14. Ohashi Y, Ishida R, Kojima T, et al. Abnormal protein profiles in tears with dry eye syndrome. Am J Ophthalmol. 2003;136(2):291–299.

    Article  Google Scholar 

  15. Green-Church KB, Butovich I, Willcox M, et al. The international workshop on meibomian gland dysfunction: report of the subcommittee on tear film lipids and lipid-protein interactions in health and disease. Invest Ophthalmol Vis Sci. 2011;52(4):1979–1993.

    Article  Google Scholar 

  16. McCulley JP, Shine WE. Meibomian gland function and the tear lipid layer. The ocular surface. 2003;1(3):97–106.

    Article  Google Scholar 

  17. Butovich IA, Millar TJ, Ham BM. Understanding and Analyzing Meibomian Lipids-A Review. Current eye research. 2008;33(5):405–420.

    Article  Google Scholar 

  18. Pucker AD, Nichols JJ. Analysis of meibum and tear lipids. Ocul Surf. 2012;10(4):230–250.

    Article  Google Scholar 

  19. Nakamura Y, Sotozono C, Kinoshita S. Inflammatory cytokines in normal human tears. Current eye research. 1998;17(6):673–676.

    Article  Google Scholar 

  20. Walter SD, Gronert K, McClellan AL, Levitt RC, Sarantopoulos KD, Galor A. omega-3 Tear Film Lipids Correlate With Clinical Measures of Dry Eye. Investigative ophthalmology & visual science. 2016;57(6):2472–2478.

    Google Scholar 

  21. Gronert K. Resolution, the grail for healthy ocular inflammation. Experimental eye research. 2010;91(4):478–485.

    Article  Google Scholar 

  22. Lambiase A, Micera A, Sacchetti M, Cortes M, Mantelli F, Bonini S. Alterations of tear neuromediators in dry eye disease. Archives of ophthalmology (Chicago, Ill: 1960). 2011;129(8):981–986.

    Article  Google Scholar 

  23. Martin XD, Brennan MC. Serotonin in human tears. Eur J Ophthalmol. 1994;4(3):159–165.

    Article  Google Scholar 

  24. Chhadva P, Lee T, Sarantopoulos CD, et al. Human Tear Serotonin Levels Correlate with Symptoms and Signs of Dry Eye. Ophthalmology. 2015;122(8):1675–1680.

    Article  Google Scholar 

  25. Stern ME, Gao J, Siemasko KF, Beuerman RW, Pflugfelder SC. The role of the lacrimal functional unit in the pathophysiology of dry eye. Experimental eye research. 2004;78(3):409–416.

    Article  Google Scholar 

  26. Paulsen FP, Berry MS. Mucins and TFF peptides of the tear film and lacrimal apparatus. Prog Histochem Cytochem. 2006;41(1):1–53.

    Article  Google Scholar 

  27. Gipson IK. Goblet cells of the conjunctiva: A review of recent findings. Prog Retin Eye Res. 2016;54:49–63.

    Article  Google Scholar 

  28. Montes-Mico R, Alio JL, Charman WN. Dynamic changes in the tear film in dry eyes. Invest Ophthalmol Vis Sci. 2005;46(5):1615–1619.

    Google Scholar 

  29. Montes-Mico R, Caliz A, Alio JL. Changes in ocular aberrations after instillation of artificial tears in dry-eye patients. J Cataract Refract Surg. 2004;30(8):1649–1652.

    Article  Google Scholar 

  30. Serhan CN. Resolution phase of inflammation: novel endogenous anti-inflammatory and proresolving lipid mediators and pathways. Annual review of immunology. 2007;25:101–137.

    Article  Google Scholar 

  31. Bazan NG, Molina MF, Gordon WC. Docosahexaenoic acid signalolipidomics in nutrition: significance in aging, neuroinflammation, macular degeneration, Alzheimer's, and other neurodegenerative diseases. Annual review of nutrition. 2011;31:321–351.

    Article  Google Scholar 

  32. Kenchegowda S, Bazan HE. Significance of lipid mediators in corneal injury and repair. Journal of lipid research. 2010;51(5):879–891.

    Article  Google Scholar 

  33. Srinivasan BD, Kulkarni PS. The role of arachidonic acid metabolites in the mediation of the polymorphonuclear leukocyte response following corneal injury. Investigative ophthalmology & visual science. 1980;19(9):1087–1093.

    Google Scholar 

  34. Bardin L. The complex role of serotonin and 5-HT receptors in chronic pain. Behav Pharmacol. 2011;22(5–6):390–404.

    Article  Google Scholar 

  35. Sommer C. Serotonin in pain and analgesia: actions in the periphery. Mol Neurobiol. 2004;30(2):117–125.

    Article  Google Scholar 

  36. Hong Y, Abbott FV. Behavioural effects of intraplantar injection of inflammatory mediators in the rat. Neuroscience. 1994;63(3):827–836.

    Article  Google Scholar 

  37. Anden NE, Olsson Y. 5-hydroxytryptamine in normal and sectioned rat sciatic nerve. Acta Pathol Microbiol Scand. 1967;70(4):537–540.

    Article  Google Scholar 

  38. Vogel C, Mossner R, Gerlach M, et al. Absence of thermal hyperalgesia in serotonin transporter-deficient mice. J Neurosci. 2003;23(2):708–715.

    Article  Google Scholar 

  39. Murphy CJ, Foster BA, Mannis MJ, Selsted ME, Reid TW. Defensins are mitogenic for epithelial cells and fibroblasts. J Cell Physiol. 1993;155(2):408–413.

    Article  Google Scholar 

  40. Schultz G, Chegini N, Grant M, Khaw P, MacKay S. Effects of growth factors on corneal wound healing. Acta Ophthalmol Suppl. 1992(202):60–66.

    Article  Google Scholar 

  41. Haynes RJ, Tighe PJ, Dua HS. Antimicrobial defensin peptides of the human ocular surface. The British journal of ophthalmology. 1999;83(6):737–741.

    Article  Google Scholar 

  42. Hampel U, Klonisch T, Sel S, et al. Insulin-like factor 3 promotes wound healing at the ocular surface. Endocrinology. 2013;154(6):2034–2045.

    Article  Google Scholar 

  43. Hampel U, Klonisch T, Makrantonaki E, et al. Relaxin 2 is functional at the ocular surface and promotes corneal wound healing. Investigative ophthalmology & visual science. 2012;53(12):7780–7790.

    Article  Google Scholar 

  44. Harvey DJ. Identification by gas chromatography/mass spectrometry of long-chain fatty acids and alcohols from hamster meibomian glands using picolinyl and nicotinate derivatives. Biomed Chromatogr. 1989;3(6):251–254.

    Article  Google Scholar 

  45. Harvey DJ. Long-chain fatty acids and alcohols from gerbil meibomian lipids. J Chromatogr. 1989;494:23–30.

    Article  Google Scholar 

  46. Harvey DJ, Tiffany JM. Identification of meibomian gland lipids by gas chromatography-mass spectrometry: application to the meibomian lipids of the mouse. J Chromatogr. 1984;301(1):173–187.

    Article  Google Scholar 

  47. Harvey DJ, Tiffany JM, Duerden JM, Pandher KS, Mengher LS. Identification by combined gas chromatography-mass spectrometry of constituent long-chain fatty acids and alcohols from the meibomian glands of the rat and a comparison with human meibomian lipids. J Chromatogr. 1987;414(2):253–263.

    Article  Google Scholar 

  48. Miyazaki M, Man WC, Ntambi JM. Targeted disruption of stearoyl-CoA desaturase1 gene in mice causes atrophy of sebaceous and meibomian glands and depletion of wax esters in the eyelid. J Nutr. 2001;131(9):2260–2268.

    Article  Google Scholar 

  49. Butovich IA, Borowiak AM, Eule JC. Comparative HPLC-MS analysis of canine and human meibomian lipidomes: many similarities, a few differences. Sci Rep. 2011;1:24.

    Google Scholar 

  50. Greiner JV, Glonek T, Korb DR, Booth R, Leahy CD. Phospholipids in meibomian gland secretion. Ophthalmic Res. 1996;28(1):44–49.

    Article  Google Scholar 

  51. Tiffany JM. The meibomian lipids of the rabbit. I. Overall composition. Experimental eye research. 1979;29(2):195–202.

    Article  Google Scholar 

  52. Tiffany JM, Marsden RG. The meibomian lipids of the rabbit. II. Detailed composition of the principal esters. Experimental eye research. 1982;34(4):601–608.

    Article  Google Scholar 

  53. Butovich IA, Lu H, McMahon A, Eule JC. Toward an animal model of the human tear film: biochemical comparison of the mouse, canine, rabbit, and human meibomian lipidomes. Investigative ophthalmology & visual science. 2012;53(11):6881–6896.

    Article  Google Scholar 

  54. Lee JH, Kee CW. The significance of tear film break-up time in the diagnosis of dry eye syndrome. Korean J Ophthalmol. 1988;2(2):69–71.

    Article  Google Scholar 

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Funding

Supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences Research EPID-006-15S (Dr. Galor), NIH Center Core Grant P30EY014801, R01EY026174 (Dr. Galor), Research to Prevent Blindness Unrestricted Grant.

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Authors and Affiliations

  1. Miami Veterans Administration Medical Center, Miami, FL, USA

    Vikram Paranjpe, Lam Phung & Anat Galor

  2. Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA

    Vikram Paranjpe, Lam Phung & Anat Galor

Authors
  1. Vikram Paranjpe
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  2. Lam Phung
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  3. Anat Galor
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Corresponding author

Correspondence to Anat Galor .

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Editors and Affiliations

  1. Department of Math Sciences, Indiana University – Purdue University I, Indianapolis, IN, USA

    Giovanna Guidoboni

  2. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Alon Harris

  3. Department of Mathematics, Polytechnic University of Milan, Milan, Italy

    Riccardo Sacco

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Paranjpe, V., Phung, L., Galor, A. (2019). The Tear Film: Anatomy and Physiology. In: Guidoboni, G., Harris, A., Sacco, R. (eds) Ocular Fluid Dynamics. Modeling and Simulation in Science, Engineering and Technology. Birkhäuser, Cham. https://doi.org/10.1007/978-3-030-25886-3_14

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