In vivo observation of tear dynamics using fluorophotometry.

Fluorophotometry was used to evaluate the effect of the blinking process on tear spreading. In normal individuals, when the intensity of fluorescence was monitored over the central 1 mm of the cornea, forceful blinking was found to substantially increase tear film thickness. Weak blinking was found to decrease tear film thickness. When tear film fluorescence was monitored along different regions of the corneal vertical meridian, the tear film thickened superiorly while thinning inferiorly. It is postulated that the vertical spreading of meibomian oils is accompanied by the movement of a portion of the aqueous tear phase that thickens the superior tear film at the expense of thinning inferiorly.