Tears are a liquid produced by the body's process of lacrimation to clean and lubricate the eyes. The word lacrimation may also be used in a medical or literary sense to refer to crying.

Physiology

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In humans, the tear film coating the eye has three distinct layers:

1. The mucous layer contains mucin secreted by the conjunctival goblet cells. The inner-most layer of the tear film, it coats the cornea to provide a hydrophobic layer that allows for even distribution of the aqueous layer.
2. The aqueous layer contains water and other substances such as proteins (e.g. tear lipocalin, lactoferrin and lysozyme^*) secreted by the glands of Kraus and Wolfring and the lacrimal gland.
3. The lipid layer contains oils secreted by the Meibomian glands. The outer-most layer of the tear film, it coats the aqueous layer to provide a hydrophobic barrier that retards evaporation.

One lacrimal gland is located above and beside each eye, behind the upper eyelid. The lacrimal glands secrete lacrimal fluid which flows through lacrimal ducts into the space between the eyeball and lids. When the eyes blink the lacrimal fluid is spread across the surface of the eye. Lacrimal fluid gathers in the lacrimal lake, then flows via the puncta through the lacrimal canaliculi at the inner corner of the eyelids through the nasolacrimal duct, and finally into the nasal cavity. An excess of tears, as with strong emotion, can thus cause the nose to run.

More on [ Tears ]

Journal of Child Health Care current issue

Children's Nursing Education: Members club or street party?
Randall, D., McTaggart, I. Wed, 20 May 2009 00:00:00 -0000

Creating space: hospital bedside displays as facilitators of communication between children and nurses
Lewis, P., Kerridge, I., Jorden, C. F.C. Wed, 20 May 2009 00:00:00 -0000
Over the past decades there has been a marked change in the physical environment of children's hospitals and the configuration of individual bed spaces. No longer the stark, clinical spaces typical of years gone by, the modern hospital bed space hosts a variety of visual displays reflecting different aspects of the child's life. Building upon ideas introduced by Lewis and informed by a recent qualitative study into hospital bedside displays, this article discusses the role that displays can play in developing, deepening and enriching relationships between nurses, patients and their families in the paediatric hospital environment. It discusses the links between hospital and home, the specific function of the display of photographs and the nurse's role in `knowing' the patient and facilitating links between hospital and home. It concludes that nurses' conscious observations of a visually rich environment may make a positive contribution to the care that they deliver for the benefit of their patients and themselves.
Influences on nurses' scoring of children's post-operative pain
Simons, J., Moseley, L. Wed, 20 May 2009 00:00:00 -0000
There is a lack of clarity as to why some nurses are not delivering optimal pain management to children post-operatively. This retrospective chart review study examined nurses' pain scoring on 175 children during the first 24 hours post-operatively. Data were analysed on the amount of assessments made, assessment scores recorded, as well as the age, gender and type of surgery performed. One-quarter of children had no assessment record of their pain in the first 24 hours post-operatively. When the pain tool was part of an observation chart, nurses recorded more pain scores. Nurses' scoring of children's pain is influenced positively by children under five years of age and those who undergo abdominal surgery. Nurses who had access to one document for recording vital signs as well as pain scores were more likely to assess and record a child's pain score than nurses who had to use a separate chart.

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