The Human Lacrimal Gland: Historical Perspectives, Current Understanding, and Recent Advances

The lacrimal glands produce the aqueous component of the pre-ocular tear film, which is essential for ocular health and optimal vision. This review explores its history, current understanding, recent advances, and scope for future research.The authors reviewed the major studies discussing the history of lacrimal glands and their anatomical description, including microscopic anatomy, innervation patterns, imaging, and ongoing translational research.The review traces the evolution of human knowledge about the source of tears across several millennia, with specific emphasis on the individuals who made seminal contributions to this field. It provides a detailed update on the morphology, microscopic structure, innervation, vascular supply, and imaging modalities of both the main and accessory lacrimal glands. The review also summarizes the recent advances in lacrimal gland regeneration and repair for the treatment of dry eye disease, particularly the role of mesenchymal stem cells. Lastly, the review gazes into the future of lacrimal gland research, which aims at translating the existing laboratory knowledge into clinical application, with the possibility of transplanting in vitro cultivated lacrimal constructs or the use of cell-based therapies for in situ repair of diseased human lacrimal glands.Knowledge about the lacrimal glands in health and disease has improved tremendously since its discovery in the mid-eighteenth century. Today we stand at the cusp of exploring potential regenerative approaches for the treatment of lacrimal gland damage in dry eye disease.