To the Editor.
—In the article "Hepatitis B Surface Antigen in Human Tears" (Archives 96:674-676, 1978), Darrell and Jacob reported the detection of hepatitis B surface antigen (HBsAg) in tears of ten HBsAg-positive patients and discussed the risks of transmitting hepatitis B by contact-lens fitting and by contact tonometry. We agree with the principle of infection hazard pointed out by the authors, and we also have several comments and corrections regarding their discussions and recommendations for measures to reduce risk of hepatitis B virus (HBV) infection.In the abstract, introduction, and comment sections of the article, the authors repeatedly stress the importance of "respiratory" and "fecaloral" modes of HBV transmission. Epidemiologic and laboratory evidence do not, in fact, support these modes as major transmission routes for HBV.1-5 Among virtually every major body fluid hypothesized as potentially infectious vehicles for HBV, blood has been considered the most important. Much of