Document Detail

Tear-film lipid layer morphology and corneal sensation in the development of blinking in neonates and infants.
MedLine Citation:
PMID:  15733299     Owner:  NLM     Status:  MEDLINE    
The aim of the study was to evaluate the role of lipid layer thickness and corneal sensation in the development of blinking in neonates. The study group comprised sixty-four neonates and infants (mean age 27.5 +/- 15 (sd) weeks, range 3.4-52) whose mothers were attending a general practice healthy baby clinic. Spontaneous eye-blink activity was determined from digital videographic recordings; tear film lipid layer morphology wasexamined using interference patterns produced by the Keeler Tearscopetrade mark Plus over a five-point grading scale (higher grades are associated with thick and stable lipid films); corneal sensation threshold was assessed with the Non-Contact Corneal Aesthesiometer (NCCA), using the eye-blink response as an objective indication that the cooling stimulus had been felt; palpebral aperture dimensions were measured using calibrated digital still images of the eye in the primary position. The overall mean spontaneous blink-rate was found to be 3.6 (+/- 0.3) blinks min(-1), and the mean interblink time was 21.6 (+/- 2.8) s. The lowest blink-rates were observed in the 0-17-week age group (average 2 blinks min(-1)). The blink-rate showed a highly significant correlation with age (r = 0.46, P < 0.01). The overall mean lipid layer grading was 3.6 (+/- 0.2 SE) arbitrary units. Higher grades were found in the newborn and the mean grading score reduced with age (P < 0.01). The mean sensation threshold to blink (TTB) was 0.69 (0.04 SE) mbar, which did not differ from a control group of older subjects (P > 0.05). There was a rapid increase in palpebral aperture length and width from birth to 1 year old, with surface area increasing by 50% over the same period. We concluded that the low rate of spontaneous eye blink activity in neonates is associated with a thick stable lipid layer that may be a function of a small palpebral aperture. Furthermore, neonates appear to have the capacity to detect ocular surface cooling, which is a major trigger for spontaneous blinking.
John G Lawrenson; Rosalind Birhah; Paul J Murphy
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of anatomy     Volume:  206     ISSN:  0021-8782     ISO Abbreviation:  J. Anat.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-28     Completed Date:  2005-06-09     Revised Date:  2013-06-09    
Medline Journal Info:
Nlm Unique ID:  0137162     Medline TA:  J Anat     Country:  England    
Other Details:
Languages:  eng     Pagination:  265-70     Citation Subset:  IM    
Henry Wellcome Laboratories for Visual Science, Department of Optometry and Visual Science, City University, London, UK.
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MeSH Terms
Blinking / physiology*
Child Development
Cold Temperature
Cornea / innervation*
Infant, Newborn
Lipids / physiology*
Neurons, Afferent / physiology*
Sensory Thresholds
Tears / physiology*
Video Recording
Reg. No./Substance:

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