Advances in clinical examination of lacrimal gland

Abstract

In humans, the lacrimal gland is located in the socket of the frontal bone above the outer orbital area. As an essential part of the eye surface, the gland is fixed to the orbital periosteum by connective tissue. The lacrimal gland passes through the outer tendon membrane, which divides the gland into larger orbital and minor eyelid glands. The lacrimal glands are the main contributors to tear film. They secrete electrolytes, proteins, and water to help nourish and protect the eye's surface. Furthermore, clinically, lacrimal glands are associated with a variety of inflammatory reactions and immune factors and are also vulnerable sites for tumors. Changes in tear gland morphology or secretory function affect tear film stability and tear secretion quality. Various technological devices have been developed and applied to lacrimal glands. This article systematically reviewed the clinical examination of the lacrimal gland to help inform personalized strategies for the diagnosis of lacrimal gland-related diseases.

Keywords: advance; clinical examination; function; lacrimal gland; morphology; review.

Figure 1

Oblique view of the right orbit. Oblique view of the right orbit showing the main lacrimal gland divided into the orbital lobe and palpebral lobe by the lateral horn of the levator aponeurosis. Note the excretory ducts coursing through the palpebral lobe and draining into the superior conjunctival fornix.

Figure 2

Sagittal view of the upper and lower eyelids. The glands of Krause (arrow) are located in the superior conjunctival fornix. The glands of Wolfring (arrowhead) are found at the nonmarginal border of the tarsal plate. Illustration from Conrady et al. (1).

Figure 3

Tear ferning (TF) images obtained before and after application of eyedrops in the right eye of (A) a dry-eye subject and (B) a normal eye subject. TF0-180, TF scores obtained 0–180 min after application of eyedrops. Illustration from Alanazi et al. (67).