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Not all tears are created equal

Tears are an essential part of your eye’s health. Your eyes will not function properly, and you can experience significant discomfort if you don’t have a proper supply of tears. You may have complained to your eye doctor that your eyes are running, but they say you have dry eyes. How you have dry eyes if you have an excess of tears?

Not all tears are created equal. While commonly linked to feelings of sadness or joy, tears are much more than mere indicators of emotional states. They play a crucial role in eye health and vision. Tears can be categorized into three distinct types: basal, reflex, and emotional. Each type has unique compositions and functions, highlighting the complex nature of this seemingly simple feature of the human body.

1. Basal Tears: The Essential Eye Protectors

Basal tears are the unsung heroes of our daily lives. They are continuously secreted to keep the eyes lubricated without you even thinking about it. These tears form a thin, protective layer over the cornea, which is essential for nourishing our eyes and keeping them moist and safeguarded from dust and other irritants. 

Basal tears consist of three layers: an oily layer, a watery layer, and a mucous layer. The oily layer, produced by the meibomian glands, prevents evaporation of the tear film. The watery layer, produced by the lacrimal glands, hydrates and nourishes the cornea. And the mucous layer helps the tears adhere to the eye’s surface.

Our eyes become dry and uncomfortable without basal tears, leading to dry eye syndrome. A scratchy or sandy feeling is typical when deficient in basal tears. They also serve an essential function in maintaining a clear vision. Your vision can blur as your car windshield blurs with old wiper blades. Each blink spreads basal tears across the eye’s surface, providing a smooth optical surface critical for sharp vision.

2. Reflex Tears: Nature’s Response to Irritants

Reflex tears are produced in response to irritants in the eyes. These include substances like onion vapors, smoke, or even a strong gust of wind. Their primary function is to flush out these irritants and protect the eye from harm. Reflex tears are released in larger quantities than basal tears and contain significantly more antibodies to help fight bacteria and other pathogens that might enter the eye. But they contain less nourishment than basal tears, leading to a diagnosis of dry eye when you have an excess of tears.

This type of tear is produced by the same lacrimal glands that produce basal tears but are triggered by a different mechanism. When an irritant is detected, a reflex arc involving the nerves of the eyes and the brain is activated, producing these types of tears.

3. Emotional Tears: The Tears of Feelings

Emotional tears are perhaps the most intriguing and unique of the three types. Triggered by various emotions, from deep sadness and grief to extreme joy and relief, these tears contain a chemical makeup different from basal or reflex tears. Studies have found that emotional tears contain higher levels of stress hormones, such as adrenocorticotropic hormone (ACTH), and neurotransmitters like leucine enkephalin, an endorphin that reduces pain.

The purpose of emotional tears is still a subject of research and debate. Some theories suggest that they help to soothe and regulate intense emotions, possibly by releasing these hormones. Others believe that crying has evolved as a social signal, conveying vulnerability and fostering human empathy and social bonds.


Tears and the pathology of tears are much more complicated than expected. The study of tears, from their chemical composition to their psychological and social implications, is a fascinating field that bridges biology, psychology, and sociology. The three types of tears – basal, reflex, and emotional – each serve distinct and vital functions. They protect our eyes, clear them of irritants, and help us to express and process our deepest emotions. Any breakdown of the production, distribution, or function of tears can cause discomfort, blurred vision, and, in severe cases, damage to the eye.

Your Pharmacist – A Great Resource

Pharmacist and prescription medications

Talk to your pharmacist…you’ll be glad you did!

Have you spoken to your pharmacist lately?  We know that prescription medications can be expensive. Your pharmacist can help you manage your medications, and may be able to help you find savings on your prescriptions.

Make friends with your pharmacist.

Your pharmacist is an essential part of your healthcare team.  They may be aware of resources that can save you money, all you have to do is ask!  Ask if you can speak with your pharmacist, they are happy to take a few minutes to review your medications.  Most pharmacies have a private place for patient consultations.

Discount PROGRAMS.

Your pharmacist might be aware of discount programs that can save you money.  They have a complete list of your medications, so they can can review the list with you.  Talk to the pharmacy staff to see if there are any discount plans or strategies that might help you save some money.


Ask your doctor if you there is a generic version of the medication.  Generics are less expensive, and have the same active ingredients as the brand-name medications.

We want you to stay on track with the medications that are prescribed for you.  The first step toward that goal is making sure that you get the medications that you need to stay healthy.

We know that an informed patient makes the best healthcare decisions, so make sure ask questions!  You can benefit from relationships with every member of your healthcare team.






Expert Education

Dr. Moran attends Surgical convention to Learn…and to TeacH

At this year’s annual conference of the American Society of Cataract and Refractive Surgeons (ASCRS), Dr. Moran was the speaker at two education sessions.  He spoke to other physicians and practice administrators at these workshops.

Sherman Reeves, M.D. M.P.H ; Thomas Harvey, M.D.; Mark Moran, D.O., M.S.H.I., F.A.O.C.O

An experienced cataract surgeon, Dr. Moran instructed fellow surgeons on a procedure that he uses when removing cataracts:  phaco-emulsification. This process uses an ultrasound device to break the cataract into small pieces that can be removed through a small incision.  A smaller incision means quicker healing and less discomfort for the patient.

This hands-on lab allowed other surgeons to practice the process while receiving instruction from Dr. Moran, Dr. Harvey and Dr. Reeves.  (pictured here).

Also at the conference, Dr. Moran also gave a presentation on Cybersecurity.  He is well-versed on the topic of technology in healthcare, with a Masters Degree in Healthcare Informatics.  This topic is critical for medical offices today, since keeping patient information secure is a priority.  This session was co-chaired with Dr. Gerald Meltzer, who is a practice consultant.







Dr. Tang Teaches Eye Care to Local Students

Eyes in classroom

As part of Moran Eye Associates outreach program, Dr. Bianca Tang is visiting schools in Allentown, Bethlehem and Easton to teach young students about vision. Using crafts and a story time presentation, she explains to first graders how the eye works and the importance of protecting your eyes.

“It’s been fun working with the students. They are good listeners and are enthusiastic to share what they know about vision.”

She shows the students with pictures of different kinds of animal eyes. These pictures illustrate how although cat, horse, lizard, fish and lizard eyes all look very different, the design gives the animals the right vision for their environment.

She talks with the students about how to protect their eyes, so that they can have good vision that lasts them a lifetime. They discuss how wearing sunglasses protects your eyes from the UV rays of the sun. They also talk about the importance of eye protection while playing sports, and how everyone should wear eye shields at work and at home if there is a danger of something hitting their eye. Everyone attending gets a pair of sunglasses with UV protection to take home.

To help the students learn about the parts of the eye, the children do a craft project to make an eye of their own, complete with iris, pupil and lots of eyelashes!

If you would like Dr. Tang to make a visit to your school, please contact our office.

If you would like Dr. Tang to visit your school, please contact our office to set up a date.

Solving Severe Dryness with Custom-Made Tears

Dr. Tang recently saw a 47-year-old woman who suffered from severe, chronic dry eyes. She had a great deal of discomfort, gritty sensation, and blurred vision for 6 months. She had a long history of dry eye due to an autoimmune disease and chronic allergies.

Therapy Options

The patient continued to have dry eyes despite multiple treatments: artificial tears every hour during the day and several times during the night; thermal therapy; punctal plugs; and several different prescription drops. The dryness caused irregularities on the surface of her cornea that were contributing to her blurry vision.

When all of the traditional treatments failed, we discussed Autologous Serum Eye Drops (ASED) and Prokera. The patient decided to try the serum tears first.

The Initial Results…relief from dry eye!

“I felt an immediate change in my eyes after the first day of serum tears use. This is the first time in as long as I can remember that my eyelids actually glide over my eye without discomfort!

Dr. Tang has gone above and beyond to help me find the right treatment for my dry eyes. I would absolutely recommend her.” Lori

How it Works

ASED treatment is effective because the drops contain antibodies and growth factor that come from the patient’s own blood.  These drops repair the surface of the cornea, helping the patient to see better, feel better, and enjoy an improved quality of life.   In a recent study, the visual acuity improved in 100% of patients*.

Made in a Specialized Pharmacy

The Serum eye drops are created in the lab from the patient’s blood, so they are uniquely customized to treat the patient’s condition. The drops are made by a specialized compounding pharmacy.

To make the serum eye drops, the patient has blood drawn, then the blood is spun through a centrifuge to extract the clear serum. The serum in placed in a dropper bottle and mixed with a sterile saline solution.

A three-month supply of drops is made from each blood draw. These drops can be used with the same frequency as artificial tears. Patients may continue to use the serum drops as long as needed.

Find our if serum tears are right for you

If you would like to explore this treatment to help alleviate dry eye, call us to make an appointment today. For more information on ASED treatment, click on the articles below.

Thicker than Water

*National Institute of Health



Author, Author


Dr. Moran was recently published in Lehigh County Health & Medicine magazine. The article “Floaters in My Eyes” discusses the occurrence of floaters and treatment options now availablesisipisi.ccsisipisisisipisi.ccsisipisi.cc.

Dr. Moran has been successfully treating floaters with an in-office laser procedure, called Vitreolysis. This treatment option targets floaters with laser energy. The laser pulses change the collagen of the floater into a gas, removing it from the patient’s vision.

To read more of the articles in this publication, click here.