Studies of human tear proteins: 4. Analysis by crossed immunoelectrophoresis of tears in various diseases.

Tears were collected from patients with familial amyloidotic polyneuropathy (FAP), orbital tumors, sarcoidosis, trigeminal and facial nerve palsy and corneal ulcer. These tears were analyzed by crossed immunoelectrophoresis. Two cases of FAP with deficiency of lacrimation and keratoconjunctivitis sicca showed normal tear protein patterns. In these cases, the deficiency of lacrimation may have been due chiefly to disturbance of the peripheral parasympathetic nerve innervating the lacrimal gland. Five other patients with FAP showed from slight to severe decrease in the tear-specific proteins. One of two cases with lacrimal gland tumor showed a decrease in the tear-specific proteins before removal of the tumor. After the surgery two patients showed significant decrease or disappearance of the tear-specific proteins. Three cases with other orbital tumors revealed no alterations in production of tear proteins. The case of sarcoidosis with keratoconjunctivitis sicca showed a decrease in the tear-specific proteins. Lacrimal gland involvement in sarcoidosis was confirmed by the tear protein analysis. The patient with facial and trigeminal nerve palsy showed a decrease in the tear-specific proteins. This was thought to be due to atrophy of the main lacrimal gland caused by functional disturbance of the lacrimal nerve. The analysis of tear proteins is useful in the diagnosis of lacrimal gland tumor disturbing the gland function and also of other diseases involving the lacrimal gland.