Clinical biochemistry of tears

The composition of tear fluid as it exists in the conjunctival fornix and in the precorneal tear film is of a complicated nature. The precorneal tear film is a physically inhomogenous system, produced by the lacrimal glands, the accessory lacrimal glands and the goblet cells of the conjunctiva and the Meibomian glands of the lid margin. The method of collection is crucial for the quantity and concentration of a great number of different compounds that have been demonstrated in tears. A survey is given of the literature concerning tears as they are composed of proteins, enzymes, lipids, metabolites, electrolytes and drugs, the latter secreted during therapy. Clinical applications of the determination of several compounds for diagnosis or for monitoring drug therapy are summarized.