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Abstract
The lacrimal gland is the major contributor to the aqueous layer of the tear film
which consists of water, electrolytes and proteins. The amount and composition of
this layer is critical for the health, maintenance, and protection of the cells of
the cornea and conjunctiva (the ocular surface). Small changes in the concentration
of tear electrolytes have been correlated with dry eye syndrome. While the mechanisms
of secretion of water, electrolytes and proteins from the lacrimal gland differ, all
three are under tight neural control. This allows for a rapid response to meet the
needs of the cells of the ocular surface in response to environmental conditions.
The neural response consists of the activation of the afferent sensory nerves in the
cornea and conjunctiva to stimulate efferent parasympathetic and sympathetic nerves
that innervate the lacrimal gland. Neurotransmitters are released from the stimulated
parasympathetic and sympathetic nerves that cause secretion of water, electrolytes,
and proteins from the lacrimal gland and onto the ocular surface. This review focuses
on the neural regulation of lacrimal gland secretion under normal and dry eye conditions.