title: Direct visualization of aqueous tear secretion from lacrimal gland.
abstract: OBJECTIVE
  To introduce a new method for direct observation of tear secretion from the palpebral lobes of the main lacrimal glands and Wolfring glands using fluorescein dye.
  
  
  METHODS
  Twenty-six patients with dry eye and 26 healthy subjects were included in the study. Fluorescein was applied to the conjunctiva overlaying the palpebral lobe of the main lacrimal glands. Under cobalt blue light, we captured tear secretion from the glands in movies. We compared the number of excretory openings, the location and tear flow rate between the dry eye and healthy-subject groups. To observe tear secretion from the Wolfring glands, we everted the upper lids and applied fluorescein dye to the upper margin of the tarsus.
  
  
  RESULTS
  Mean number of excretory openings on the palpebral lobe was 2.5 in the dry eye group and 3.4 in the healthy-subject group (p = 0.031). Most of the openings were observed at the ridge, the most protruding portion of the palpebral lobe. Mean flow rate from the palpebral lobe was 0.45 μl/min in the dry eye group and 0.91 μl/min in the healthy-subject group (p = 0.046). Mean flow rate from the Wolfring glands was 0.007 μl/min in the dry eye group and 0.009 μl/min in the healthy-subject group (p = 0.615).
  
  
  CONCLUSIONS
  This visualization method allowed us to directly observe tear secretion from the palpebral lobe of the main lacrimal glands and Wolfring glands, and to quantitatively measure the tear flow rate from the lacrimal glands.
authors.affiliation: Department of Ophthalmology, Bucheon St. Mary's Hospital, Catholic University of Korea, Bucheon, Korea.
authors.forename: Eun Chul
authors.initials: EC
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, St. Paul's Hospital, Catholic University of Korea, Seoul, Korea.
authors.forename: Sang Hee
authors.initials: SH
authors.lastname: Doh
authors.affiliation: Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, Korea.
authors.forename: Se Yoon
authors.initials: SY
authors.lastname: Chung
authors.affiliation: Department of Ophthalmology, Gangdong Sacred Heart Hospital, Hallym University, Seoul, Korea.
authors.forename: Sam Young
authors.initials: SY
authors.lastname: Yoon
authors.affiliation: Department of Ophthalmology, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.
authors.forename: Man Soo
authors.initials: MS
authors.lastname: Kim
authors.affiliation: Department of Ophthalmology, St. Paul's Hospital, Catholic University of Korea, Seoul, Korea.
authors.forename: Sung Kun
authors.initials: SK
authors.lastname: Chung
authors.affiliation: Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, Korea.
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Shin
authors.affiliation: Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University, Chuncheon, Korea.
authors.forename: Ho Sik
authors.initials: HS
authors.lastname: Hwang
mesh_terms: D000287:Administration, Topical; D000328:Adult; D003228:Conjunctiva; D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000378:metabolism; D005260:Female; D019793:Fluorescein / Q000008:administration & dosage*; D005456:Fluorescent Dyes / Q000008:administration & dosage; D006801:Humans; D007765:Lacrimal Apparatus / Q000000981:diagnostic imaging / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D013666:Tears / Q000378:metabolism*; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D005456:Fluorescent Dyes; D019793:Fluorescein
keywords: Wolfring gland; fluorescein dye; lacrimal gland; palpebral lobe; tear flow rate