We appreciated reading Dr Menon's data demonstrating that the more premature the infant, the less the total and reflex tear secretion by the infant when stimulated to cry. These data support the results in our study as shown in Figure 2 and Figure 3.1 Although Dr Menon did not submit any statistical analysis, by χ2 analysis, the difference between the more premature and term infants was significant for total tear secretion (P=.004) and when crying (P=.03). The less premature infants were different than term infants only when crying (P=.02).
Isenberg SJ, Apt L. Lacrimal Secretion in the Neonate. Arch Ophthalmol. 2000;118(6):861. doi: