Observations made in 1936 by Rollet are reconfirmed and elaborated. The factors found to be associated with spot-wise drying of the tear film were reduced tear volume, irregularities of the corneal surface, widened palpebral fissures, and abnormalities of the lid margin which prevented efficient blinking motions. When corneal sensation was normal, this tear-film drying stimulated blinking. However, when drying occurred in patients with reduced corneal sensation, blinking was delayed, the epithelium was desiccated, and erosions could be seen. This form of keratitis sicca was most common in the aged and could occur with a normal tear volume, especially in those patients with wide palpebral fissures.
Brown SI. Further Studies on the Pathophysiology of Keratitis Sicca of Rollet. Arch Ophthalmol. 1970;83(5):542-547. doi:10.1001/archopht.1970.00990030542004