Background: Some patients can wear contact lenses with a low tear breakup time while others with an identical tear breakup time cannot wear lenses. This suggests the current method of tear film assessment is inadequate at differentiating between these two types of patients. The study attempts to expand our knowledge of the tear film with special attention directed to a critical yet little studied component: mucin. Mucin is vital to maintenance of the tear film and functions as a tear film stabilizer. The condition of the precorneal tear film is a major determinant in the success of contact lens wear.
Methods: Eighteen subjects free of ocular surface disease who had never worn contact lenses had the goblet cell density of their inferior bulbar conjunctiva determined by impression cytology. The subjects were then fit in a 38 percent water polymacon lens and their goblet cell density determined on a monthly basis for 6 months.
Results: Nearly a 2-fold increase in goblet cell density was observed in 88 percent of the subjects over the 6-month period. The first statistically significant increase occurred 5 months after the initiation of lens wear when the goblet cell density rose from 4.19-7.84 percent.
Conclusions: We speculate the increase in goblet cells is an adaptive response of the ocular surface to a coated daily wear contact lens.