The effect of cigarette smoke on the human tear film.
We used a corneal microscope to measure the break up time of the tear film (BUT) in 14 young volunteers; four were men and all were non-smokers. Values under controlled conditions and after ten minutes of exposure to filtered air or to cigarette smoke in a room of 14.6 m3 were determined. Exposure to cigarette smoke was associated with a substantial (35--40%) and statistically significant (P less than 0.001) reduction of BUT. This may reflect an alteration in the relative proportions of the three constituents of the tear film. The chemical responsible, and the way in which it increases the flow of watery constituents and suppresses mucus and lipid secretion demand further research.