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To the Editor.—
I would like to offer some comments on the article entitled "Blinking and Blepharospasm" (1982; 248:3160) by Jankovic and co-workers. In the opening sentence of the section on pathogenesis, the authors quote a reference from Hall from 1945 regarding the clinical significance of spontaneous blinking. Actually, a great deal of knowledge about blinking and tear film physiology has been gained in the 37 years since that article was written. The tear film is extremely important for the health of the eye. Without this layer over the eye's surface, corneal epithelium would die and slough off and blindness would eventually ensue. That this does not occur is testimony to the importance of the tear film and the blink response. Unfortunately, the tear film is thin (about 7 μm) and unstable. If a normal person is prevented from blinking, the tear film will break up (rupture) in about 20
Lamberts DW. Blinking and Blepharospasm. JAMA. 1983;249(22):3016. doi:10.1001/jama.1983.03330460016012