Tears

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Anatomy of lacrimation, showing

a) Lacrimal gland
b) Superior lacrimal punctum
c) Superior lacrimal canal
d) Lacrimal sac
e) Inferior lacrimal punctum
f) Inferior lacrimal canal
g) Nasolacrimal canal

Tearing (/ˈtɪərɪŋ/), lacrimation, or

lachrymation (from Latin lacrima, meaning
'tear') is the secretion of tears, a body fluid
which often serves to clean and lubricate
the eyes in response to an irritation of the
eyes.[1] Tears formed through crying are
associated with strong internal emotions,
such as sorrow, elation, love, awe, and
pleasure. Laughing or yawning may also
lead to the production of tears.

Physiology
In humans, the tear film coating the eye,
known as the precorneal film, has three
distinct layers, from the most outer
surface:[2]
 Name Container(s) Secretors Functions

Coats the
aqueous
layer,
provides a
hydrophobic
barrier that
envelops
tears and
prevents
their spilling
onto the
Meibomian cheek.
Lipid glands (or These
Oils
layer tarsal glands are
glands) found
among the
tarsal
plates.
Thus, the
tear fluid
deposits
between the
eye proper
and oil
barriers of
the lids.[3]

Aqueous Electrolytes, 60 metabolites—Amino Acids (1- Lacrimal Promotes

layer Methylhistidine/3-Methylhistidine, Arginine, Asymmetric, gland spreading
Asymmetric dimethylarginine/Symmetric of the tear
dimethylarginine, Citrulline, Creatine, Glutamine, film, the
Homoarginine, Hydroxyproline, Phenylalamine, Proline, control of
Pyroglutamic acid, Serine, Taurine, Theonine, Tryptophan, infectious
Tyrosine, Urocanic acid, Valme), Amino Alcohols agents and
(Panthenoll); Amino Ketones (Allantoin, Creatine), osmotic
Aromatic Acids (Cinnamic acid, o-Coumaric acid/m- regulation.
 Coumaric acid/p-Coumaric acid), Carbohydrates (N-
Acetylneuraminic acid), Carnitines (Acetylcarnitine,
Carnitine, hexanoylcarnitine, Palmitoylcarnitine); Cyclic
Amines (Niacinamide); Dicarboxylic Acids (Fumaric acid/
Maleic acid), Nucleosides (1-Methyladenosine,
Adenoisine, Cytidine, Guanosine, Inosine, S-Adenosyl-
homocysteine, S-Adenosyl-methionine, Uridine, and
Xamthosine), Nucleotides (ADP, AMO, CMP, Cytidine
diphosphate choline, GMP, IMP, UDP, UMP, UDP-N-
acetylgalactosamine/UDP-N-acetylglucosamine),
Peptides (Oxidized glutathione), Phospholipids (1-
Palmitoyl-lysophosphatidylcholime), Purines and
derivatives (Hypoxanthine, Theobromine, Uric acid,
Xanthine), Purines and derivatives (4-Pyridoxic acid),
Quaternary Amines (Acetylcholine,
Glycerolphosphocholine, Phosphocholine), and
Tricarboxylic Acids (Citric acid)--and other substances
such as proteins (e.g., antibodies,[2] lipocalin, lactoferrin,
lysozyme,[4] and lacritin)

Coats the
cornea,
provides a
hydrophilic
Mucous Conjunctival layer and
Mucins
layer goblet cells allows for
even
distribution
of the tear
film.

Having a thin tear film may prevent one's

ability to wear contact lenses, as the
amount of oxygen needed is higher than
normal, and contact lenses stop oxygen
from entering the eye. Eyes with thin tear
film will dry out while wearing contact
lenses. Special eye drops are available for
contact lens wearers. Certain types of
contact lenses are designed to let more
oxygen through to the eye.

Drainage of tear film

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The lacrimal glands secrete lacrimal fluid,

which flows through the main excretory
ducts into the space between the eyeball
and lids. When the eyes blink, the lacrimal
fluid is spread across the surface of the
eye. Lacrimal fluid gathers in the lacrimal
lake, and is drawn into the puncta by
capillary action, then flows through the
lacrimal canaliculi at the inner corner of
the eyelids entering the lacrimal sac,[3]
then on to the nasolacrimal duct, and
finally into the nasal cavity. An excess of
tears, as with strong emotion, can thus
cause the nose to run. [1]

Types
There are three very basic types of tears:[1]
Category Description

In healthy mammalian eyes, the cornea is continually kept wet and nourished by
basal tears. They lubricate the eye, and help to keep it clear of dust. Tear fluid
contains water, mucin, lipids, lysozyme, lactoferrin, lipocalin, lacritin,
immunoglobulins, glucose, urea, sodium, and potassium. Some of the substances in
lacrimal fluid (such as lysozyme) fight against bacterial infection as a part of the
Basal
immune system. Lysozyme does this by dissolving a layer in the outer coating, called
tears
peptidoglycan, of certain bacteria. It is a typical body fluid with a salt content similar
to blood plasma. Usually, in a 24-hour period, 0.75 to 1.1 grams (0.03–0.04 ounce
avoirdupois) of tears is secreted; this rate slows with age.[3] In addition, the basal
tears are composed of antioxidants such as Ascorbate, Urate, Cysteine, Glutathione,
and Tyrosine. Ascorbate and Urate constitute half of the tears.

The second type of tears results from irritation of the eye by foreign particles, or
from the presence of irritant substances such as onion vapors, perfumes and other
fragrances, tear gas, or pepper spray in the eye's environment, including the cornea,
Reflex
conjunctiva, or nasal mucosa, which trigger TRP channels in the ophthalmic nerve.[5]
tears
It can also occur with bright light and hot or peppery stimuli to the tongue and
mouth. It is also linked with vomiting, coughing and yawning.[3] These reflex tears
attempt to wash out irritants that may have come into contact with the eye.

The third category, in general, referred to as crying or weeping, is increased tearing

due to strong emotional stress, pleasure, anger, suffering, mourning, or physical pain.
This practice is not restricted to negative emotions; many people cry when extremely
happy such as during times of intense humour and laughter. In humans, emotional
tears can be accompanied by reddening of the face and sobbing — cough-like,
convulsive breathing, sometimes involving spasms of the whole upper body. Tears
Crying or
brought about by emotions have a different chemical make-up than those for
weeping
lubrication; emotional tears contain more of the protein-based hormones prolactin,
(psychic
adrenocorticotropic hormone, and Leu-enkephalin (a natural painkiller) than basal or
tears)
reflex tears. The limbic system is involved in production of basic emotional drives,
such as anger, fear, etc. The limbic system, to be specific, the hypothalamus, also
has a degree of control over the autonomic system. The parasympathetic branch of
the autonomic nervous system controls the lacrimal glands via the neurotransmitter
acetylcholine through both the nicotinic and muscarinic receptors. When these
receptors are activated, the lacrimal gland is stimulated to produce tears.[6]
A toddler producing tears due to emotional stress or
pain

Neural aspects

The trigeminal V1 (fifth cranial) nerve

bears the sensory pathway of the tear
reflexes. When the trigeminal nerve is cut,
tears from reflexes will stop, but not
emotional tears.The lacrimal nerve from
cranial nerve VII innervates the lacrimal
gland, which is located within the orbit. It
is responsible for production of much of
the aqueous portion of the tear film. For
this reason, if someone has signs of facial
nerve problems, tear production should be
checked. Likewise, application of cocaine
to the surface of the eye, due to its
paralyzing effect on the sensory nerve
endings, inhibits the reflex even under
exposure to strong tear gases. The motor
pathway is autonomic (involuntary), and, in
general, uses the pathway of the facial
(seventh) nerve in the parasympathetic
division. In parasympathetic imitators
(such as acetylcholine), more tears are
produced, and an anticholinergic drug like
atropine inhibits tear production. A
newborn infant has insufficient
development of nervous control, so s/he
"cries without weeping." If the lacrimal
gland malfunctions or is damaged (e.g. by
surgery), but does not cause any severe
drying of the cornea, it is not a serious
matter, for the accessory glands are
enough for general secretion. In reflex
situations, copious tears are produced
mainly in emergencies.[3]

Diseases and disorders

Quality of vision is affected by the stability
of the tear film.[7]

"Crocodile tears syndrome", also known as

Bogorad's syndrome, is an uncommon
consequence of nerve regeneration
subsequent to Bell's palsy or other
damage to the facial nerve in which
efferent fibers from the superior salivary
nucleus become improperly connected to
nerve axons projecting to the lacrimal
glands, causing one to shed tears
(lacrimate) during salivation while
smelling foods or eating. It is presumed
that one would also salivate while crying
due to the inverse improper connection of
the lacrimal nucleus to the salivary glands,
but this would be less noticeable.[8][9]

Keratoconjunctivitis sicca, known as dry

eye, is a very common disorder of the tear
film. However, sufferers can experience
watering of the eyes, which is in fact a
response to irritation caused by the
original tear film deficiency. Lack of
Meibomian gland secretion can mean the
tears are not enveloped in a hydrophobic
film coat, leading to tears spilling onto the
face.

Familial dysautonomia is a genetic

condition that can be associated with a
lack of overflow tears (alacrima) during
emotional crying.[10]

Obstruction of the punctum, nasolacrimal

canal, or nasolacrimal duct can cause
even normal levels of basal tear to
overflow onto the face (epiphora), giving
the appearance of constant psychic
tearing. This can have significant social
consequences.

Social aspects

Crying boy
In nearly all cultures, crying is associated
with tears trickling down the cheeks and
accompanied by characteristic sobbing
sounds. Emotional triggers are most often
sadness and grief but crying can also be
triggered by anger, happiness, fear,
laughter or humor, frustration, remorse, or
other strong, intense emotions. In many
cultures, crying is associated with babies
and children. Some cultures consider
crying to be undignified and infantile,
casting aspersions on those who cry
publicly, except if it is due to the death of a
close friend or relative. In most cultures, it
is more socially acceptable for women and
children to cry than men. In some Latin
regions, crying among men is
acceptable.[11][12][13]

Some modern therapy movements such as

Re-evaluation Counseling teach that crying
is beneficial to health and mental well-
being, encouraging it positively.[14] An
insincere display of grief or dishonest
remorse is sometimes called crocodile
tears in reference to an Ancient Greek
anecdote that crocodiles would pretend to
weep while luring or devouring their
prey.[15] In addition, in medical terms,
someone is said to have crocodile tears
syndrome as an uncommon consequence
of recovery from Bell's palsy, in which
faulty regeneration of the facial nerve
causes sufferers to shed tears while
eating.

Chemicals in tears
On a study conducted by the Weizmann
Institute of Science in Rehovot, Israel,
emotional tears from women have been
found to reduce sexual arousal in men.
Also, emotional tears are made up of a
different chemical component than those
evoked by eye irritants and can relay
chemical messages to others.[16] The
change in sex drive could be attributed to
a drop in testosterone provoked by the tear
chemicals, reducing aggression. In the
animal world, it has been found that some
blind mole rats rub tears all over their
bodies as a strategy to keep aggressive
mole rats away.[17]

Tear composition varies from tear types.

Mainly, tears are composed of water, salts,
antibodies and lysozymes (antibacterial
enzymes). According to a discovery by Dr.
William H. Frey II, a bio-chemist from St.
Paul Ramsey medical center in Minnesota,
the composition of tears caused by
emotion differs from that of tears as a
reaction to irritations, such as onion
fumes, dust or allergy. Emotional tears are
composed of more protein-based
hormones, such as prolactin,
adrenocorticotropic, and leucine
enkephalin (a natural pain killer), which is
suggested to be the mechanism behind
the experience of crying from emotion
making an individual feel better.[18]

See also
Wikimedia Commons has media related to
Tears.

Artificial tears
Dacryocystocele
Epiphora
 Eyelid
Professional mourning
Sadness

References
1. Farandos, NM; Yetisen, AK; Monteiro, MJ;
Lowe, CR; Yun, SH (2014). "Contact Lens
Sensors in Ocular Diagnostics". Advanced
Healthcare Materials. 4 (6): 792–810.
doi:10.1002/adhm.201400504 .
PMID 25400274 .
2. Moshirfar M, Pierson K, Hanamaikai K,
Santiago-Caban L, Muthappan V, Passi SF
(July 2014). "Artificial tears potpourri: a
literature review" . Clin Ophthalmol. 8:
1419–33. doi:10.2147/OPTH.S65263 .
PMC 4124072 . PMID 25114502 .
3. "eye, human."Encyclopædia Britannica
from Encyclopædia Britannica 2006
Ultimate Reference Suite DVD 2009
4. "Ocular Pathology Study Guide: Tear
Proteins" . medrounds.org. Archived from
the original on 2006-06-27.
5.
http://cdn.intechopen.com/pdfs/31117/InT
ech-
Transient_receptor_potential_trp_channels_i
n_the_eye.pdf
6. Skorucak A. "The Science of Tears."
ScienceIQ.com. Accessed September 29,
2006.
7. Szczesna DH, Jaroński J, Kasprzak HT,
Stenevi U (2006). "Interferometric
measurements of dynamic changes of tear
film" . J Biomed Opt. 11 (3): 34028.
doi:10.1117/1.2209881 . PMID 16822077 .
Archived from the original on 2012-07-13.
8. Morais Pérez D, Dalmau Galofre J, Bernat
Gili A, Ayerbe Torrero V (1990). "[Crocodile
tears syndrome]". Acta Otorrinolaringol Esp
(in Spanish). 41 (3): 175–7.
PMID 2261223 .
9. McCoy, FJ; Goodman, RC (Jan 1979).
"The crocodile tear syndrome". Plastic and
Reconstructive Surgery. 63 (1): 58–62.
doi:10.1097/00006534-197901000-00010 .
PMID 432324 .
10. Felicia B Axelrod; Gabrielle Gold-von
Simson (October 3, 2007). "Hereditary
sensory and autonomic neuropathies: types
II, III, and IV" . Orphanet Journal of Rare
Diseases. 2 (39): 39. doi:10.1186/1750-
1172-2-39 . PMC 2098750 .
PMID 17915006 .
11. Dianne Hales (October 2005). "Big Boys
Don't Cry — and Other Myths About Men
and Their Emotions (page 2 of 3)" . Reader's
Digest. Retrieved 2008-07-20.
12. Fran Metcalf (8 May 2008). "These days
it's OK for men to cry, say famous guys" .
The Courier Mail. Retrieved 3 June 2015.
13. John-Paul Flintoff (August 30, 2003).
"Why we cry" . The Age. Retrieved
2008-07-20.
14. Re-evaluation Counseling site: "The
Recovery Process" Archived 2006-12-11 at
the Wayback Machine
15. "World Wide Words: Crocodile tears" .
World Wide Words.
16. Weaver, Janelle. Crying Women Turn
Men Off". Scientific American Mind,
May/June 2011, p. 22, 6.
17. Dell'Amore, Christine. " Women's Tears
Reduce Sex Drive in Men, Study Hints" ,
"National Geographic, January 6, 2011,
accessed June 6, 2011.
18. Frey, William H.; Desota-Johnson,
Denise; Hoffman, Carrie; McCall, John T.
(October 1981). "Effect of Stimulus on the
Chemical Composition of Human Tears".
American Journal of Ophthalmology. 92 (4):
559–567. doi:10.1016/0002-
9394(81)90651-6 . PMID 7294117 .

External links
Wikiquote has quotations related to: Tears

Look up tears in Wiktionary, the free

dictionary.

Nasolacrimal System Anatomy at

eMedicine
 PERSONAL HEALTH By JANE E. BRODY,
published February 22, 1984

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