LACRIMAL GLAND ,TEAR FILM, ANDDRY EYE SYNDROMES 2Basic Science and Clinical Relevance

David A. SullivanDarlene A. Dartt

Michele A. Meneray

Advances in experimental medicine and biology ; v .

438 .

Conference Address

1 . A Clinician Looks at the Tearfilm

1J. Daniel Nelso n

Lacrimal Gland : Cellular and Molecular Biology

2. Influence of Gender, Sex Steroid Hormones, and the Hypothalamic-PituitaryAxis on the Structure and Function of the Lacrimal Gland 1 1

David A. Sullivan, L. Alexandra Wickham, Eduardo M . Rocha ,Robin S . Kelleher, Lilia Aikawa da Silveira, and Ikuko Toda

3 . Androgen-Regulated Transcription in the Epithelium of the Rat Lacrimal Gland

4 3F. Claessens, H . Vanaken, I . Vercaeren, G . Verrijdt, A. Haelens ,

E. Schoenmakers, P. Alen, A. Devos, B . Peeters, G. Verhoeven ,W. Rombauts, and W. Heyns

4. Gene Cloning of BM 180, a Lacrimal Gland Enriched Basement Membran eProtein with a Role in Stimulated Secretion 49

Anil C . Asrani, Angela J . Lumsden, Rajesh Kumar, and Gordon W. Laurie

5 . Sensory Denervation Leads to Deregulated Protein Synthesis in the Lacrima lGland 55

Doan H . Nguyen, Roger W. Beuerman, Michele A. Meneray, andDmitri Maitchouk

6. Acinar Cell Basal-Lateral Membrane-Endomembrane Traffic May Mediat eInteractions with Both T Cells and B Cells 63

Austin K . Mircheff, Tao Yang, Jian Zhang, Hongtao Zeng, J . Peter Gierow,Dwight W. Warren, and Richard L . Wood

7. Tissue Expression of Tear Lipocalin in Humans

69Catherine Ressot, Herve Lassagne, Jean-Louis Kemeny, and

Anne-Marie Francoise Gachon

33 . Soluble Mucin and the Physical Properties of Tears

22 9John M. Tiffany, Jyotin C . Pandit, and Anthony J . Bro n

34 . Characterization and Origin of Major High-Molecular-Weight TearSialoglycoproteins 23 5

Robert A . Sack, Bruce Bogart, Sonal Sathe, Ann Beaton, and George Lew

35. Detection and Quantification of Conjunctival Mucins

239James E . Jumblatt and Marcia M. Jumblatt

36 . Mucous Contribution to Rat Tear-Film Thickness Measured with aMicroelectrode Technique 24 7

Philip Anderton and Sophia Tragoulia s

37 . Structural Analysis of Secreted Ocular Mucins in Canine Dry Eye

253Stephen D . Carrington, Sally J . Hicks, Anthony P. Corfield ,

Renee L . Kaswan, Nicki Packer, Shirley Bolis ,and Carol A. Morri s

38 . Corneal Epithelial Tight Junctions and the Localization of Surface Mucin

265Henry F. Edelhauser, David E . Rudnick, and Ramzy G . Azar

39. Breakup and Dewetting of the Comeal Mucus Layer : An Update

273Ashutosh Sharma

Meibomian Gland and Tear Film Lipids: Structure, Function, and Contro l

40. The Meibomian Glands and Tear Film Lipids : Structure, Function,and Control 28 1

Anthony J. Bron and John M. Tiffan y

41 . Tear Film Interferometry as a Diagnostic Tool for Evaluating Normal an dDry-Eye Tear Film 297

Marshall G. Doane and M . Estella Lee

42. Human and Rabbit Lipid Layer and Interference Pattern Observations

305Donald R . Korb, Jack V. Greiner, Thomas Glonek, Amy Whalen ,

Stacey L. Hearn, Jan E . Esway, and Charles D . Leahy

43 . Abnormal Lipid Layers : Observation, Differential Diagnosis, and Classification

309Jean-Pierre Guillon

44. Association of Tear Lipid Layer Interference Patterns with Superficial Punctat eKeratopathy 31 5

Aoi Komuro, Norihiko Yokoi, Yoko Takehisa, and Shigeru Kinoshit a

45 . Meibomian Secretions in Chronic Blepharitis

31 9James P. McCulley and Ward E . Shine

46. Androgen Regulation of the Meibomian Gland

32 7David A. Sullivan, Eduardo M . Rocha, M . David Ullman ,

Kathleen L. Krenzer, Jianping Gao, Ikuko Toda ,M. Reza Dana, Dorothy Bazzinotti, Lilia Aikawa da Silveira, andL. Alexandra Wickham

47. Delivery of Meibomian Oil Using the Clinical Meibometer®

33 3John M. Tiffany, Anthony J. Bron, Federico Mossa, and Shabtay Dikstein

48 . Volume of the Human and Rabbit Meibomian Gland System

339Jack V. Greiner, Thomas Glonek, Donald R . Korb, Amy C . Whalen ,

Eric Hebert, Stacey L . Hearn, Jan E. Esway, and Charles D . Leahy

49 . Effect of Meibomian Gland Occlusion on Tear Film Lipid Layer Thickness . . . . 345Jack V. Greiner, Thomas Glonek, Donald R . Korb, Stacey L . Hearn ,

Amy C . Whalen, Jan E . Esway, and Charles D . Leahy

Tear Film Stability, Evaporation, and Biophysic s

50 . Meibomian Gland Lipids, Evaporation, and Tear Film Stability

34 9William D. Mathers and James A . Lane

51 . Surface-Chemical Pathways of the Tear Film Breakup : Does Corneal Mucu sHave a Role? 36 1

Ashutosh Sharma

52. The Biophysical Role in Tear Regulation

37 1Alan Tomlinson, Jennifer P. Craig, and Gerald E . Lowther

53 . Longitudinal Analysis of Precorneal Tear Film Rupture Patterns

38 1Etty Bitton and John V. Lovasi k

54. The Role of Tear Proteins in Tear Film Stability in the Dry Eye Patient and i nthe Rabbit 39 1

Ronald D. Schoenwald, Sangeeta Vidvauns, Dale Eric Wurster, andCharles F. Barfknecht

55 . Relationship between Pre-Ocular Tear Film Structure and Stability

40 1Michel Guillon, Cecile Maissa, and Elaine Style s

56 . Association of Precorneal and Preconjunctival Tear Film

407Yoko Takehisa, Norihiko Yokoi, Aoi Komuro, and Shigeru Kinoshit a

57 . Age and Gender Effects on the Normal Tear Film

41 1Jennifer P. Craig and Alan Tomlinson

58 . The Kinetics of Lid Motion and Its Effects on the Tear Film

417

A. Berke and S . Mueller

59 . Hydrodynamics of Meniscus-Induced Thinning of the Tear Film

425

Ashutosh Sharma, Sanjay Tiwari, Rajesh Khanna, and John M. Tiffany

60. Computer-Assisted Calculation of Exposed Area of the Human Eye

433John M. Tiffany, Bryan S . Todd, and Mark R. Baker

Cytokines, Growth Factors, Proto-Oncogenes, and Apoptosis

61 . Cytokines: An Overview

44 1James T. Rosenbaum, Beatriz Brito, Young Boc Han, Jongmoon Park, and

Stephen R. Planck

62 . Gender- and Androgen-Related Impact on the Expression of Proto-Oncogene sand Apoptotic Factors in Lacrimal and Salivary Glands of Mouse Model sof Sjögren's Syndrome 447

Ikuko Toda, L. Alexandra Wickham, Eduardo M . Rocha ,Lilia Aikawa da Silveira, and David A . Sullivan

63 . Apoptosis in the Lacrimal Gland and Conjunctiva of Dry Eye Dogs

453Jianping Gao, Tammy A. Gelber-Schwalb, John V. Addeo, and

Michael E . Stern

64. Cytokines and Tear Function in Ocular Surface Disease

46 1Keith Barton, Alexandra Nava, Dagoberto C . Monroy, an d

Stephen C . Pflugfelder

65 . Chemokine Production in Conjunctival Epithelial Cells

47 1Kazumi Fukagawa, Kazuo Tsubota, Shigeto Simmura, Hirohisa Saito ,

Hiroshi Tachimoto, Akira Akasawa, and Yoshihisa Oguch i

66 . Molecular Basis and Role of Differential Cytokine Production in T Helper Cel lSubsets in Immunologic Disease 479

Andrea Keane-Myers, Vincenzo Casolaro, and Santa Jeremy On o

67. Presence and Testosterone Influence on the Levels of Anti- an dPro-Inflammatory Cytokines in Lacrimal Tissues of a Mouse Model o fSjögren'sSyndrome 48 5

Eduardo M . Rocha, L. Alexandra Wickham, Zhiyan Huang, Ikuko Toda ,Jianping Gao, Lilia Aikawa da Silveira, and David A . Sullivan

68. Infiltrating Lymphocyte Populations and Cytokine Production in the Salivar yand Lacrimal Glands ofAutoimmune NOD Mice 493

Christopher P. Robinson, Janet Cornelius, Denise I. Bounous ,Hideo Yamamoto, Michael G . Humphreys-Beher, and Ammon B . Peck

69. Do Cytokines Have a Role in the Regulation of Lacrimal Gland Acinar Cell Io nTransport and Protein Secretion? 499

R. William Lambert

70 . The Rat Exorbital Lacrimal Gland as a Site of Synthesis of EGF-like GrowthFactors 505

Herve Marechal, Helene Jammes, Bernard Rossignol, and Philippe Mauduit

71 . The Distribution of FGF-2 and TGF-ß within the Lacrimal Gland of Rabbits . . . 51 1Joel Schechter, Dwight W. Warren, and Richard L . Wood

72 . Tear Fluid Changes after Photorefractive Keratectomy

51 5Minna Vesaluoma and Timo Terv o

73 . Time Course of Apoptosis in Lacrimal Gland after Rabbit Ovariectomy

52 3Ana Maria Azzarolo, Richard L . Wood, Austin K. Mircheff, Eric Olsen ,

Zuo Ming Huang, Ramin Zolfagari, and Dwight W. Warren

74. Co-Expression of BCL-2 and CD44S in Basal Layers of Human Ocular Surfac eEpithelia 527

Andrew J. W. Huang, Cheng-Hui Li, You-Wei Chen, andLilly Y. W. Bourguignon

75 . Alterations of Ocular Surface Gene Expression in Sjögren's Syndrome

53 3David T. Jones, Dagoberto Monroy, Zhongua Ji, and Stephen C . Pflugfelder

76 . Growth Factor Interaction with Contact Lenses : Evidence for and PossibleEffects of Storage of Basic FGF in Contact Lenses : Preliminary Results . . 53 7

G.-B. van Setten and N. Zengin

Inflammation and Immunity

77 . Neural, Endocrine, and Immune System Interactions : Relevance for Health andDisease 54 1

Jan A. Moynihan, Barbara Kruszewska, Gary J . Brenner, and Nicholas Cohen

78 . Inductive Sites for Rat Tear IgA Antibody Responses

55 1Deanne M. Ridley Lathers, Randall F. Gill, Nancy L. O'Sullivan, and

Paul C . Montgomery

79. Anatomy of Mammalian Conjunctival Lymphoepithelium

55 7James Chodosh, Robert E . Nordquist, and Ronald C . Kennedy

80. Binding of a Cytopathic or an Invasive Strain of P. aeruginosa to Cytoskeletal,Basement Membrane, or Matrix Proteins of Wounded Cornea Is Similarand Does Not Rely on Interaction with Actin Filaments 567

Linda D. Hazlett and Sharon Masinick

81 . Secretory IgA Responses on the Human Ocular Surface

57 5Aize Kijlstra

82 . A Method to Study Induction of Autoimmunity in Vitro : Co-Culture of LacrimalCells and Autologous Immune System Cells 58 3

Harvey R . Kaslow, Zhijun Guo, Dwight W. Warren, Richard L . Wood, andAustin K. Mircheff

83. Rat Lacrimal Glands Contain Activated and Resting Mature T Cells, Recen t

Thymic Emigrants, and Possibly Extrathymic Populations 59 1

Nancy L. O'Sullivan, Cheryl A . Skandera, and Paul C. Montgomery

84 . Immunohistochemical Examination of Lacrimal Gland Tissue from Patient swith Ocular Sarcoidosis 599

Janine A. Smith, Chi-Chao Chan, Charles E . Egwuagu, and Scott M. Whitcup

85 . Immunoglobulin Levels in the Tears of Patients with Corneal Grafts an dTransplant Rejection 603

Andras Berta and Zsolt Lampe

Tear Film Components and Influence on the Ocular Surfac e

86. Tear Fluid Influence on the Ocular Surface

61 1Stephen C . Pflugfelder

87 . Effects of Lacrimal Gland Removal on Squirrel Monkey Cornea

619Dmitri Y. Maitchouk, Roger W. Beuerman, Ray J . Yarnell, and

Lia Pedroza-Schmid t

88 . Lacrimal Gland Growth Factors and Receptors : Lacrimal Fibroblastic Cells Area Source of Tear HGF 625

S . E . Wilson, Q . Li, R. R. Mohan, T. Tervo, M . Vesaluoma, G. L. Bennett ,R. Schwall, K. Tabor, J . Kim, S . Hargrave, and K. H. Cueva s

89 . Clusterin May Be Essential for Maintaining Ocular Surface Epithelium as aNon-Keratinizing Epithelium 629

Kohji Nishida, Satoshi Kawasaki, and Shigeru Kinoshit a

90 . Effects of Chronic Hypertonic Stress on Regulatory Volume Increase andNa-K-2C1 Cotransporter Expression in Cultured Corneal Epithelial Cells

637Victor N. Bildin, Hua Yang, Jorge Fischbarg, and Peter S . Reinach

91 . A Unified Theory of the Role of the Ocular Surface in Dry Eye

643Michael E . Stem, Roger W. Beuerman, Robert I . Fox, Jianping Gao,

Austin K . Mircheff, and Stephen C . Pflugfelder

92 . Human Tear Film Components Bind Pseudomonas aeruginosa

653Nancy A. McNamara and Suzanne M. J . Fleiszig

93 . Small-Volume Analysis of Rabbit Tears and Effects of a Corneal Wound on TearProtein Spectra 659

Ray J. Vamell, Dmitri Y. Maitchouk, Roger W. Beuerman, James E . Carlton ,and Anthony Haag

94. 3 1 -27 kDa Caseinolytic Protease in Human Tears

665Miki Sakata, Ann R. Beaton, Sonal Sathe, and Robert A . Sack

95 . Tear Protein Levels following Punctal Plugging

669E. Ian Pearce, Alan Tomlinson, Jennifer P. Craig, and Gerald E . Lowther

96 . Characterization of Cells Shed from the Ocular Surface in Normal Eyes

675Carolyn G . Begley, Jie Zhou, and Graeme Wilson

97. Healing Effect of Sodium-Sucrose-Octasulfate and EGF on Epithelial Cornea lAbrasions in Rabbits 68 3

Sven Johansen, Steffen Heegaard, Kirsten Bjerrum, and Jan Ulrik Prause

98 . A Novel Approach to Resolve Cellular Volume Responses to an AnisotonicChallenge 687

Pavel Iserovich, Peter S . Reinach, Hua Yang, and Jorge Fischbarg

Artificial Tears and Contact Lenses : Impact on the Tear Film and Ocular Surfac e

99. Classification of Artificial Tears : I : Composition and Properties

69 3J . Murube, A. Paterson, and E . Murube

100. Classification of Artificial Tears : II : Additives and Commercial Formulas

70 5J . Murube, A. Murube, and Chen Zhu o

101 . The Ocular Surface, the Tear Film, and the Wettability of Contact Lenses

71 7Carol A . Morris, Brien A. Holden, Eric Papas, Hans J . Griesser,

Shirley Bolis, Philip Anderton, and Fiona Carne y

102 . Conjunctival Permeability and Ultrastructure : Effects of Benzalkonium Chlorid eand Artificial Tears 723

John L. Ubels, Eric M. Woo, William J . Watts, Lisa K . Smith, Uko Zylstra ,Jonnell Beaird, and Mitchell D . McCartney

103 . Preservative Effect on Epithelial Barrier Function Measured with a NovelTechnique 73 1

Jerry R . Paugh, Alan Sasai, and Abhay Josh i

104 . Video Biomicroscopy of the Tear Film

73 7P. Noel Dilly, Michel Guillon, and Lucia McGrogan

105. Patient-Dependent and Material-Dependent Factors in Contact Lens DepositionProcesses 74 5

Brian J . Tighe, Lyndon Jones, Kathryn Evans, and Valerie Frankli n

106. Effectiveness of Bion Tears, Cellufresh, Aquasite, and Refresh Plus fo r

Moderate to Severe Dry Eye 753

Peter C . Donshik, J . Daniel Nelson, Mark Abelson, James P. McCulley,Cliff Beasley, and Robert A . Laibovitz

107. Ocular Residence Time of Carboxymethylcellulose Solutions

76 1

Jerry R. Paugh, Ronald C. Chatelier, and Joseph W. Huff

108. Vitronectin Adsorption in Contact Lens Surfaces during Wear : Locus and

Significance 769

Brian J . Tighe, Valerie Franklin, Christopher Graham, Aisling Mann, and

Michel Guillon

109 . Effect of Tears and Tear Residues on Worn Etafilcon and Polymacon Disposable

Contact Lenses on the Adhesion of Pseudomonas aeruginosa 77 5

Miguel F. Refojo, Fee-Lai Leong, and Marta Portole s

110 . Hyaluronan in Dry Eye and Contact Lens Wearers

785

Monica Berry, William K . Pastis, Roger B . Effingham, Louise Frost ,

Anthony P. Corfield, and David L. Easty

Classification, Diagnosis, Clinical Features, and Epidemiology of Dry Eye Syndromes

111 . Epidemiology and Classification of Dry Eye

79 1

Michael A . Lemp

112 . CANDEES : The Canadian Dry Eye Epidemiology Study

805

Barbara E . Caffery, Doris Richter, Trefford Simpson, Desmond Fonn,

Michael Doughty, and Keith Gordo n

113 . Sensitivity and Specificity of a Screening Questionnaire for Dry Eye

807

Neal L . Oden, David E . Lilienfeld, Michael A. Lemp, J . Daniel Nelson, andFred Ederer

114 . Use of a Questionnaire for the Diagnosis of Tear Film-Related Ocular Surfac eDisease 82 1

Maurizio Rolando, Angelo Macri, Trillo Carlandrea, and Giovanni Calabri a

115 . Importance of Conjunctival Epithelial Evaluation in the Diagnosti cDifferentiation of Dry Eye from Drug-Induced Epithelial Keratopathy . . . 827

Norihiko Yokoi and Shigeru Kinoshita

116 . The Size of Corneal Epithelial Cells Collected by Contact Lens Cytology fromDry Eyes 83 1

Graeme Wilson and John Lauren t

117 . Optimum Dry Eye Classification Using Questionnaire Responses

83 5Charles McMonnies, Arthur Ho, and Denis Wakefield

118 . Diagnostic Value of Tear Film Abnormalities in a New Syndrome Affecting theNeuroendocrine and Immune Systems 839

Janos Feher

119 . Low-Tech Detection of Tear Film-Related Diseases of the Ocular Surface

84 5Maurizio Rolando, Salvatore Alongi, Angelo Macri, Marco Schenone, an d

Giovanni Calabri a

120 . Using LIPCOF (Lid-Parallel Conjunctival Fold) for Assessing the Degree o fDry Eye, It Is Essential to Observe the Exact Position of That Specifi cFold 85 3

Frank Schirra, Helmut Höh, Christina Kienecker, and Klaus W. Ruprecht

121 . Use of the Tearscope Plus and Attachments in the Routine Examination of theMarginal Dry Eye Contact Lens Patient 859

Jean-Pierre Guillo n

122 . Evaluation of Schirmer Tests by Two Types of Tear Clearance Tests

869Masafumi Ono, Yukiko Yagi, Eiki Goto, Hao-Yung Yang, and Kazuo Tsubota

123 . Fluorescein Dye Concentration as a Factor in Tear Film Fluorescence

87 5Victor M. Finnemore, Donald R. Korb, Jack V. Greiner, Thomas Glonek, an d

John P. Herman

124. A New Method for Measuring Human Basic Tear Fluid Osmolality

87 9Pierre L . Emond and Christopher J. Corbett

125 . Micropachometric Quantification of Tear Assessment Tests

88 3Hans W. Roth and Rolf Marquardt

126 . Use of Corneal Thickness Changes to Compare the Efficacy of ConventionalEye Drops with Supracutaneous Treatment of Dry Eye 887

Hans W. Roth

Pathogenesis of Dry Eye Syndromes

127 . Sjögren 's Syndrome : Pathogenesis and New Approaches to Therapy

89 1Robert I . Fox

128. Reflex Tearing in Dry Eye Not Associated with Sjögren's Syndrome

903Kazuo Tsubota

129. Cytokine mRNA Expression in Labial Salivary Glands and Cytokine Secretionin Parotid Saliva in Sjögren's Syndrome 909

Philip C . Fox, Margaret M. Grisius, Debra K. Bermudez, and Di Sun

130. Age-Related Decrease in Innervation Density of the Lacrimal Gland in MouseModels of Sjögren's Syndrome 91 7

Benjamin Walcott, Nidia Claros, Alp Patel, and Peter R. Brink

131 . Aberrant Expression and Potential Function for Parotid Secretory Protein (PSP)in the NOD (Non-Obese Diabetic) Mouse 92 5

Christopher P. Robinson, Denise I. Bounous, Connie E. Alford,Ammon B . Peck, and Michael G . Humphreys-Beher

132. Survey of Canine Tear Deficiency in Veterinary Practice

93 1

Renee Kaswan, Christopher Pappas, Jr., Keith Wall, and Susan G. Hirsh

133. Lacrimation and Salivation Are Not Related to Lymphocytic Infiltration inLacrimal and Salivary Glands in MRL lpr/lpr Mice 94 1

Hiromi Fujita, Tsutomu Fujihara, Tsutomu Takeuchi, Ichiro Saito, an dKazuo Tsubota

134 . The Sjögren Syndrome and Tear Function Profile

949

0. Paul van Bijstervel d

Management and Therapy of Dry Eye Syndrome s

135. Cytokines May Prove Useful in the Treatment of Sjögrens Syndrome (SS) Dry

Eye 953Norman Talal, Tom Nakabayashi, John J. Letterio, Liping Kong ,

Andrew G . Geiser, and Howard Dang

136. The Now and Future Therapy of the Non-Sjögren's Dry Eye

959

Gary N . Foulk s

137. Dry Eye Treatment with Eye Drops that Stimulate Mucin Production

965Takashi Hamano

138. A Dose-Ranging Clinical Trial to Assess the Safety and Efficacy ofCyclosporine Ophthalmic Emulsion in Patients with Keratoconjunctiviti sSicca 969

Joseph Tauber, for the Cyclosporine Study Group

139. Oral Pilocarpine for Symptomatic Relief of Dry Mouth and Dry Eyes in Patient swith Sjögrens Syndrome 973

A. S . Papas, M . M. Fernandez, R . A. Castano, S . C. Gallagher, M. Trivedi ,and R. C. Shrotriy a

140. Oral Pilocarpine for Symptomatic Relief of Keratoconjunctivitis Sicca inPatients with Sjögren's Syndrome 979

J . D . Nelson, M . Friedlaender, R. P. Yeatts, R. Yee, M. McDermott, S . Orlin ,S . C. Gallagher, R. C. Shrotriya, and the MGI PHARMA Sjögren' sSyndrome Study Group

141 . Supracutaneous Treatment of Dry Eye Patients with Calcium Carbonate

98 5Donald L . MacKeen, Hans Walter Roth, Marshall G. Doane, and

Patricia D . MacKeen

142. Preclinical Safety Studies ofCyclosporine Ophthalmic Emulsion

99 1O. Angelov, A . Wiese, Y. Yuan, J. Andersen, A . Acheampong, and B . Brar

143 . Conjunctival Impression Cytology from Dogs with Keratoconjunctivitis Sicca:Pre- and Post-Treatment with Topical Cyclosporine 997

Denise I . Bounous, Kathleen L . Krenzer, Renee L . Kaswan, andSusan G. Hirsh

144 . Cyclosporine Distribution into the Conjunctiva, Cornea, Lacrimal Gland, an dSystemic Blood following Topical Dosing of Cyclosporine to Rabbit ,Dog, and Human Eyes 100 1

Andrew Acheampong, Martha Shackleton, Steve Lam, Patrick Rudewicz ,and Diane Tang-Liu

145 . Estrogen Therapy in Keratoconjunctivitis Sicca

100 5Jinus Akramian, Andreas Wedrich, Johannes Nepp, and Michael Sato r

146. Dry Eye Treatment with Acupuncture : A Prospective, Randomized,Double-Masked Study 101 1

J . Nepp, A. Wedrich, J . Akramian, A . Derbolav, C. Mudrich, E . Ries, andJ. Schauersberger

147. Punctal Occlusion for the Treatment of Dry Eye

101 7Mitchell H . Friedlaender and Robert I . Fox

148. Keratoprosthesis in Pemphigoid and Stevens-Johnson Syndrome

102 1Claes H . Dohlman and Hisao Terada

149. Portable Device for Programmable, Automatic, or On-Demand Delivery o f

Artificial Tears 1027

Vo Van Toi and P. A. Grounauer

Contributors

1033. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Index 1037