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1.
Apt  LCullen  BF Newborns do secrete tears.  JAMA. 1964;189951- 953Google ScholarCrossref
2.
Isenberg  SEverett  S Cardiovascular effects of mydriatics in low-birth-weight infants.  J Pediatr. 1984;105111- 112Google ScholarCrossref
3.
Isenberg  SJHyman  PAbrams  C Effect of cyclopentolate eyedrops on gastric secretory function in pre-term infants.  Ophthalmology. 1985;92698- 700Google ScholarCrossref
4.
Halberg  GPBerens  C Standardized Schirmer tear test kit.  Am J Ophthalmol. 1961;51840- 842Google Scholar
5.
Mutch  JR The lacrimation reflex.  Br J Ophthalmol. 1944;28317- 336Google ScholarCrossref
6.
Sjogren  H The lacrimal secretion in newborn premature and fully developed children.  Acta Ophthalmol. 1955;33557- 560Google ScholarCrossref
7.
McEwen  WK Secretion of tears and blinking. Davson  Hed. The Eye Vol 3 New York, NY Academic Press Inc1962;271- 305Google Scholar
8.
Patrick  RK Lacrimal secretion in full term and premature babies.  Trans Ophthalmol Soc U K. 1974;94283- 289Google Scholar
9.
Spiegler  CMayer  UM Über die Tranenproduktion bei frühgeborenen neugeborenen und sauglingen.  Klin Monatsbl Augenheilkd. 1993;20224- 26Google ScholarCrossref
10.
Jordan  ABaum  J Basic tear flow: does it exist?  Ophthalmology. 1980;87920- 930Google ScholarCrossref
11.
Mansour  AMCheng  KPMumma  JV  et al.  Congenital dacryocele: a collaborative review.  Ophthalmology. 1991;981744- 1751Google ScholarCrossref
12.
Goldberg  MFPayne  JWBrunt  PW Ophthalmologic studies of familial dysautonomia.  Arch Ophthalmol. 1968;80732- 743Google ScholarCrossref
13.
Kieth  CGBolt  DW Congenital absence of the lacrimal gland.  Am J Ophthalmol. 1986;102800- 801Google Scholar
14.
Mondino  BJBrown  SI Hereditary congenital alacrima.  Arch Ophthalmol. 1976;941478- 1480Google ScholarCrossref
15.
Henderson  JWPrough  WA Influence of age and sex on flow of tears.  Arch Ophthalmol. 1950;43224- 231Google ScholarCrossref
16.
Wright  JCMeger  GE A review of the Schirmer test for tear production.  Arch Ophthalmol. 1962;67564- 565Google ScholarCrossref
17.
Lamberts  DWFoster  SPerry  HD Schirmer test after topical anesthesia and the tear meniscus height in normal eyes.  Arch Ophthalmol. 1979;971082- 1085Google ScholarCrossref
Clinical Sciences
June 1998

Development of Tearing in Preterm and Term Neonates

Author Affiliations

From the Jules Stein Eye Institute, Department of Ophthalmology, Harbor–University of California–Los Angeles Medical Center, Torrance, and University of California–Los Angeles School of Medicine.

Arch Ophthalmol. 1998;116(6):773-776. doi:10.1001/archopht.116.6.773
Abstract

Background  Although term and preterm infants have the capacity to secrete tears, the relative contribution of basal and reflex secretion of tears has not been previously assessed together in a prospective study. This information potentially has practical clinical importance.

Objectives  To measure basal and reflex tear secretion in preterm (30-37 weeks after conception) and term (38-42 weeks) newborns and to determine the developmental pattern of tear production.

Methods  Tear secretion was evaluated by applying Schirmer tear test strips to the inferior fornix for 5 minutes before (reflex plus basal secretion) and after (basal secretion) applying a topical anesthetic agent.

Results  Seventy infants (36 preterm and 34 term) were tested. Mean (± SD) basal tear secretion was 6.2 (± 4.5) mm in preterm and 9.2 (± 4.3) mm in term infants and increased progressively with increasing weight (P<.001) for all newborns. Mean (± SD) reflex tear secretion was 7.4 (± 4.8) mm in preterm and 13.2 (± 6.5) mm in term infants and also increased with increasing weight (P<.001) for all newborns.

Conclusions  Preterm infants have reduced reflex and basal tear secretion. This may mask the diagnosis of a nasolacrimal duct obstruction, concentrate topically applied medications, and allow corneas to quickly become dry during ophthalmological examination and treatment. By term, tear production in newborns is similar to that in adults.

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