title: Is the main lacrimal gland indispensable? Contributions of the corneal and conjunctival epithelia.
abstract: The ocular surface system is responsible for ensuring that the precorneal tear film is sufficient in both quality and quantity to preserve optimal vision. Tear secretion is a complex, multifactorial process, and dysfunction of any component of the ocular surface system can result in tear film instability and hyperosmolarity with resultant dry eye disease. The tear film is primarily composed of lipids, aqueous, and mucins, with aqueous accounting for most of its thickness. The aqueous is produced by the main lacrimal gland, accessory lacrimal glands, and corneal and conjunctival epithelia. Although the main lacrimal gland has long been considered an indispensable source of the aqueous component of tears, there is evidence that adequate tear secretion can exist in the absence of the main lacrimal gland. We review and discuss the basics of tear secretion, the tear secretory capacity of the ocular surface, and emerging treatments for dry eye disease.
authors.affiliation: Department of Ophthalmology and Vision Science, The University of Arizona College of Medicine, Tucson, Arizona, USA.
authors.forename: William
authors.initials: W
authors.lastname: Stevenson
authors.affiliation: PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
authors.forename: Sangeethabalasri
authors.initials: S
authors.lastname: Pugazhendhi
authors.affiliation: Department of Ophthalmology and Vision Science, The University of Arizona College of Medicine, Tucson, Arizona, USA. Electronic address: mwang@eyes.arizona.edu.
authors.forename: Mingwu
authors.initials: M
authors.lastname: Wang
mesh_terms: D003228:Conjunctiva / Q000473:pathology*; D003315:Cornea / Q000378:metabolism / Q000473:pathology*; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007765:Lacrimal Apparatus / Q000378:metabolism* / Q000473:pathology; D009077:Mucins / Q000378:metabolism*; D013666:Tears / Q000737:chemistry / Q000378:metabolism*
chemical_list: D009077:Mucins
keywords: accessory lacrimal gland; conjunctival epithelium; corneal epithelium; diquafosol; main lacrimal gland; ocular surface system; rebamipide; tear secretion