PHYSIOLOGY OF TEAR PRODUCTION, STRUCTURE & FUNCTION OF TEAR

FILM AND DRAINAGE OF TEARS

The main role of lacrimal film is to establish and maintain continuous tear film over
the ocular surface. The presence of pre-corneal film was first demonstrated by
Fischer in 1928. Rollet described it as the most superficial 6 th layer of cornea. Wolff
was the first to describe the tear film in detail. He coined the term PRE-CORNEAL
FILM. Tear film consists of 3 layers:

Outer Lipid layer (Meibomian glands)

Intermediate Aqueous layer (main and accessory lacrimal glands)
Inner Mucin layer (goblet cells within conjunctiva)

MUCIN LAYER:
Innermost, thinnest layer
Consists of mucin secreted by conjunctival goblet cells and Glands of
Manz
Converts hydrophobic corneal surface into hydrophilic
Plays a vital role in stability of tear film
Lubricates ocular and palpebral surfaces
Provides a slippery coating over foreign bodies, thereby protecting the
cornea and conjunctiva against the abrasive effects of such particles as
they move about with blinking.
AQUEOUS LAYER:
Forms bulk of tear film

 Secreted mainly by main lacrimal and accessory glands of Krause and

Wolfring
Comprise of mainly water, and small quantities of solutes such as NaCl, urea,
sugar and proteins thus its alkaline and salty
Buffering capacity is because of presence of HCO 3 and proteins in this layer
It has antibacterial substances such as betalysin, lysozyme, lactoferrin
Provides O2 and nutrients to cornea
Washes off irritants and debris
LIPID (OR OILY) LAYER:

Outermost layer formed at air-tear interface

Formed from secretions of Meibomian, Zeis, and Moll glands
Prevents overflow of tears
Reduces their evaporation
Lubricates eyelids as they slide over surface of globe

FUNCTIONS OF TEAR FILM:

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Keeps conjunctiva and cornea moist

Provide O2 to corneal epithelium
Washes away debris and noxious irritants
Presence of anti-bacterial substances prevents infections
Facilitates movement of lids over globe
Provides perfect refractive media for light

SECRETION OF TEARS
Tears are continuously produced throughout the day by accessory (basal
secretions) and main lacrimal glands (reflex secretions). Reflex secretions are
produced in response to sensations from cornea and conjunctiva, probably
produced by evaporation and breakup of tear film.
Sensory pathway (afferent) of the tear reflex is through Trigeminal Nerve (V1), while
secretomotor (efferent) pathway is autonomic, and involves the pathway through
facial nerve (CN 7) in the parasympathetic division via
pterygopalatine/sphenopalatine ganglion

ELIMINATION OF TEARS:
Tears flow down and medially reaching lower fornix inner canthus (via
lacus lacrimalis) lacrimal passages nasal cavity
This is brought about by active lacrimal mechanical pump, which is due to
fibers of orbicularis oris (especially Horners muscle/ preseptal fibers) inserted
on lacrimal sac.

During blinking:
Contraction of fibers

Distension of lacrimal sacs fundus

Negative pressure created

Brings tears from canaliculi from punctum

and prevents reflux (via valve of
Rosenmuller)

During opening of eyelids:

Horners muscle relaxes

Lacrimal sac collapses

Creates a positive pressure

Tears forced down the Nasolacrimal duct,

into the nose (Reflux prevented by Hasners
valve)