[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
[Skip to Content Landing]
April 1978

Osmolarity of Tear Microvolumes in Keratoconjunctivitis Sicca

Author Affiliations

From the College of Physicians and Surgeons, Department of Ophthalmology, Columbia University (Mr Gilbard and Drs Farris and Santamaria) and the Department of Ophthalmology, Harlem Hospital Medical Center, New York (Dr Farris).

Arch Ophthalmol. 1978;96(4):677-681. doi:10.1001/archopht.1978.03910050373015

• Determinations of tear film osmolarity were performed to evaluate their usefulness in diagnosing keratoconjunctivitis sicca (KCS) and to evaluate the possible role of elevated tear osmolarity in this disorder's pathogenesis. Tear samples were obtained using a new technique that virtually eliminates the problems of reflex tearing and sample evaporation. The tear osmolarity of 36 samples obtained from 31 normal eyes averaged 302 ± 6.3 (SD) mOsm/liter; 38 samples obtained from 30 KCS eyes averaged 343 ± 32.3 (SD) mOsm/liter. The sensitivity of a single measurement was 94.7% and the specificity was 93.7%. Tear samples taken on separate occasions from one normal subject ranged between 295 and 309 mOsm/liter; those obtained from a KCS patient ranged between 312 and 424 mOsm/liter. Hyperosmolarity of the tear film in KCS may play an important role in inducing the disease seen in the cornea and conjunctiva.

Sjögren H:  Keratoconjunctivitis sicca , in Ridley F, Sorsby A, (eds): Modern Trends in Ophthalmology . London, Butterworth & Co, Ltd, 1940, pp 403-413.
Wright JC, Merger GE:  A review of the Schirmer test for tear production . Arch Ophthalmol 67:564-565, 1962.Article
Van Bijsterveld OP:  Diagnostic tests in the sicca syndrome . Arch Ophthalmol 82:10-14, 1969.Article
Beetham WP:  Filamentary keratitis . Trans Am Ophthalmol Soc 33:413-435, 1935.
Lemp MA:  Artificial Tear Solutions . Int Ophthalmol Clin 13:221-229, 1973.Article
Baum JL:  Systemic disease associated with tear deficiencies . Int Ophthalmol Clin 13:157-184, 1973.Article
Scherz W, Doane MG, Dohlman CH:  Tear volume in normal eyes and keratoconjunctivitis sicca . Albrecht von Graefes Arch Klin Ophthalmol 192:141-150, 1974.Article
Lemp MA, Dohlman CH, Kuwabara T, et al:  Dry eye secondary to mucus deficiency . Trans Am Acad Ophthalmol Otolaryngol 75:1223-1227, 1971.
McEwen WK:  Secretion of tears and blinking , in Davson H, (ed): The Eye . New York, Academic Press, 1962, vol 3, pp 271-305.
Lemp MA, Hamill JR:  Factors affecting tear film breakup in normal eyes . Arch Ophthalmol 89:103-105, 1973.Article
Henderson JW:  Keratoconjunctivitis sicca: A review with a survey of 121 additional cases . Am J Ophthalmol 33:197-223, 1950.
Holm S:  Keratoconjunctivitis sicca and the sicca syndrome . Acta Ophthalmol Suppl 33:1-230, 1949.
Haas EB:  The pathogenesis of keratoconjunctivitis sicca . Ophthalmologica 147:1-18, 1964.Article
Shearn MA:  Ocular Aspects , in Smith LH (ed): Sjögren's Syndrome . Philadelphia, WB Saunders Co, 1971, vol 2, pp 21-37.
Scherz W, Dohlman CH:  Is the lacrimal gland dispensable? Keratoconjunctivitis sicca after lacrimal gland removal . Arch Ophthalmol 93:281-283, 1975.Article
Von Bahr G:  Könnte der Flüssigkeitsabgang durch die Cornea von physiologischer Bedeutung Sein? Acta Ophthalmol 19:125-134, 1941.Article
Balik J:  The lacrimal fluid in keratoconjunctivitis sicca: A quantitative and qualitative investigation . Am J Ophthalmol 35:773-782, 1952.
Mastman GJ, Baldes EJ, Henderson JW:  The total osmotic pressure of tears in normal and various pathologic conditions . Arch Ophthalmol 65:509-513, 1961.Article
Mishima S, Kubota Z, Farris RL:  The tear flow dynamics in normal and in keratoconjunctivitis sicca cases , in Solanes MP (ed): Ophthalmology, Proceedings of the XXI International Congress, Mexico, DF, 8-14 March, 1970 . Amsterdam, Excerpta Medica, 1971, pt 2, pp 1801-1805,
Vanley GT, Leopold IH, Gregg TH:  Interpretation of tear film breakup . Arch Ophthalmol 95:445-448, 1977.Article
Sjögren H, Bloch KJ:  Keratoconjunctivitis sicca and the Sjögren syndrome . Surv Ophthalmol 16:145-159, 1971.
Robbins SL: Pathologic Basis of Disease . Philadelphia, WB Saunders Co, 1974, pp 32, 1113.
Anderson WAD: Pathology . St. Louis, CV Mosby Co, 1971, vol 1, p 77.
Mishima S:  Some physiological aspects of the precorneal tear film . Arch Ophthalmol 73:233-241, 1965.Article
Brown SI, Mishima S:  The effect of intralamellar water-impermeable membranes on corneal hydration . Arch Ophthalmol 76:702-708, 1966.Article