Tears (tear film) are a transparent fluid secreted primarily by the lacrimal glands (tear gland) found in the eyes of all land mammals. According to the mode of production, tears are classified into four types: basal, closed eye, emotional, and reflex. The basal rate of tear secretion is ~0.5–2.2 μL/min, and irritation can increase secretion by up to ~100-fold, reaching ~300 μL/min. Tears are made up of water, electrolytes, proteins, lipids, and mucins that form layers on the surface of eyes. The four types of tears differ significantly in their composition.
Some of the functions of tears include lubricating the eyes (basal tears), removing irritants (reflex tears), and also aiding the immune system. Tears also occur as a part of the body's natural pain response. Emotional secretion of tears may serve a biological function by excreting stress-inducing hormones built up through times of emotional distress. Tears have symbolic significance among humans.
Physiology
Chemical composition Tear film was described in 1946 by Wolff using a slit lamp to have a three-layered structure: lipid, aqueous, and mucous. Tears are composed of water, salts, antibodies, and lysozymes (antibacterial enzymes). The composition of each layer determines its function. For example, the diverse lipid classes in the tear film lipid layer (TFLL) confer unique physicochemical properties that support roles such as enabling thin film formation and preventing its collapse onto the ocular surface. More recently, Mazyar Yazdani at Oslo University Hospital proposed that the TFLL may also contribute to corneal oxygenation, based on its composition-driven properties. The composition varies among different tear types. The composition of tears caused by an emotional reaction differs from that of tears as a reaction to irritants, such as onion fumes, dust, or allergens. Emotional tears contain higher concentrations of stress hormones such as adrenocorticotropic hormone and leucine enkephalin (a natural pain killer), which suggests that emotional tears play a biological role in balancing stress hormone levels.
Drainage of tear film The lacrimal glands secrete lacrimal fluid, which flows through the main excretory ducts into the space between the eyeball and the lids. When the eyes blink, the lacrimal fluid is spread across the surface of the eye. Lacrimal fluid gathers in the lacrimal lake which is found in the medial part of the eye. The lacrimal papilla is an elevation in the inner side of the eyelid, at the edge of the lacrimal lake. The lacrimal canaliculi open into the papilla. The opening of each canaliculus is the lacrimal punctum. From the punctum, tears will enter the lacrimal sac, then on to the nasolacrimal duct, and finally into the nasal cavity. An excess of tears, as caused by strong emotion, can cause the nose to run. Quality of vision is affected by the stability of the tear film.
Types There are three basic types of tears: basal, reflex and emotional.
Nictitating membrane Some mammals, such as cats, camels, polar bears, seals and aardvarks, have a full translucent third eyelid called a nictitating membrane, while others have a vestigial nictitating membrane. The membrane works to protect and moisten the eyelid while maintaining visibility. It also contributes to the aqueous portion of the tear film and possibly immunoglobulins. Humans and some primates have a much smaller nictitating membrane; this may be because they do not capture prey or root vegetation with their teeth, so that there is no evolutionary advantage of the third eyelid.
Neurology The trigeminal V1 (fifth cranial) nerve bears the sensory pathway of the tear reflexes. When the trigeminal nerve is cut, tears from reflexes will stop, while emotional tears will not. The great (superficial) petrosal nerve from cranial nerve VII provides autonomic innervation to the lacrimal gland. It is responsible for the production of much of the aqueous portion of the tear film.
Human culture
In nearly all human cultures, crying is associated with tears, active tear ducts and abrupt strong respiration, due to strong emotional impetuses. Triggers of crying can vary from sadness and grief to intense anger, happiness, fear, mirth, frustration, confusion, and any form of overwhelming stimuli. Emotional tears can also be triggered by social and personal experiences, like listening to music, reading social media content, sharing thoughts, and communicating. Crying is often associated with babies and children. The infants that are unable to vocally communicate have many alternating tones in their crying, attracting the attention of the caregiver and specifically their biological mothers. Blood-related mothers go through physiological changes upon exposure to the crying, with a deceleration in heart rate, followed by a quick acceleration, as well as understanding the vocalizations of the baby's crying. This is a mother-specific case, as the other caregivers, like biological father or adoptive parents, are not able to decode the sound. Some cultures consider crying to be undignified and infantile, casting aspersions on those who cry in public settings, excluding circumstances which concerns loss of a relative or a loved one. In most Western cultures, it is more socially acceptable for women and children to cry than men, reflecting masculine sex-role stereotypes. There is evidence for an interpersonal function of crying as tears express a need for help and foster willingness to help in an observer. Some modern psychotherapy movements such as Re-evaluation Counseling encourage crying as beneficial to health and mental well-being. An insincere display of grief or dishonest remorse is sometimes called crocodile tears in reference to an Ancient Greek anecdote that crocodiles would pretend to weep while luring or devouring their prey. In addition, "crocodile tears syndrome" is a colloquialism for Bogorad's syndrome, an uncommon consequence of recovery from Bell's palsy in which faulty regeneration of the facial nerve causes people to shed tears while eating.
Pathology
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