The Vitality of Lacrimal Glands

March 2024

By Richard Fleming

Photo courtesy of Jeremy Wong

The human body is comprised of 78 remarkable organs which help sustain normal life. Five – the heart, brain, lungs, kidneys, and liver – are particularly crucial and are commonly referred to as “vital organs.” Other body parts, while important, are not as essential as our vital organs. We can live without our tonsils or appendix. Even our gall bladder is dispensable. But we cannot live without our heart.

In the hierarchy of importance, one internal organ gets short shrift. It is not labeled a vital organ in any medical textbook. I feel it is past time to give this body part more respect. The organ I am referring to is the lacrimal gland, commonly known as the tear gland. We have two of these magical organs, one above each eye. In my view, our lacrimal glands can make a viable claim to be vital organs. Granted, they may not be as important as our heart or lungs. But without functioning lacrimal glands, our quality of life would suffer. And this is especially true for seniors.

Why is tear production so important? And why is it especially valuable for old folks? Tears serve two principal functions, one physiologic, the other emotional.

Physiologically, tears lubricate our eyes. Maintaining moist eyes is crucial for normal vision and eye health. Our lacrimal glands work 24 hours a day to keep our eyes from drying out. If our eyes are not kept moist, we cannot clearly see the world around us and the road ahead.

And lacrimal glands serve an important role in our emotional well-being because they enable us to cry. Emotional crying is critical to healthy living. It is a uniquely human activity. Tears can express feelings of overwhelming joy or consuming sorrow. Crying can be a powerful affirmation of love or a plaintive request for support. Tears communicate with our fellow humans in ways that words alone cannot. Crying can release emotional tension. Without crying, we would tend to keep feelings bottled up inside, contributing to problems like hypertension, depression, and a weakened immune system.

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People of all ages benefit from tear production, but this is especially true for seniors. Our lacrimal glands assume greater importance over time, both physiologically and emotionally.

As we age, our eyes also grow old. Our eyeballs stiffen and our vision becomes less sharp. Ironically, this happens at the same time that font sizes on medication bottles and food packages start shrinking. Tear production can help slow the anatomical decline of our eyes, so hopefully we know whether to take that blue capsule twice or three times a day.

And emotions frequently become more intense as we grow older. Aging can be accompanied by feelings of profound happiness. Children get married. Grandchildren are born. We witness the upcoming generations establishing themselves, leaving childhood behind, and taking the baton to work for a better future. Seniors often celebrate these happy milestones with tears of joy.

But a fundamental part of growing old is also the certainty of increasing loss. The toll of family members passing mounts. Friends fall by the wayside. The winding down of our bodies and the unavoidable truth of what lies ahead cannot be denied.

So we older folks also cry tears of sadness. Sometimes we cry in the presence of our family and friends. And sometimes we cry alone, sitting quietly in a bedroom or at the kitchen table. As our years accumulate and our horizons draw closer, tears tend to more frequently reflect grief than joy. But these tears of sadness can be therapeutic and help us deal with the mysterious and uncertain challenges of growing old.

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As I think back on my years in medical practice, I recall many memories of old people crying. Rare was the clinic day untouched by tears. So many seniors feeling loss. So many seniors feeling lost.

And I remember the poignant tears of my own aging family members.

My father approaching death from cancer at age 68. He could barely move from bed, and on one visit I leaned in and gave him a long hug. When I finally sat back, he was crying and said, “This is what I am going to miss the most. Hugging.” I had to look away.

My mother-in-law sitting mutely on our family room sofa, unable to speak after a stroke. She sat stiffly, quietly, and then tears began to trickle down her cheeks. She must have known what was to come a few days later. Crying was the only way she could express herself.

My mother, lying in bed at a skilled nursing facility after a stroke left her so incapacitated she could not read. She could not watch TV. She could not bathe or dress herself. As tears ran down her face one day, she said, “Please make me the happiest mom in the world and help this end.”

A few months ago, my 60 year old brother with Down syndrome and dementia, sitting at our kitchen table drinking his morning coffee. After my wife asked him a question, he paused, hit the side of his head a few times, then started crying. “I can’t remember things so good,” he said. Then he took another sip of coffee and stared quietly into space.

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We are all traveling further into the dappled light of the deep woods. We each take different paths and face unique challenges, though we share much. As we journey forward, it can become increasingly difficult to recall the beauty and to smile at the satisfactions of a life well lived. Loss envelops us more and more, year by year. Its grip grows tighter. The pain is real.

And our lacrimal glands respond as designed. The need to cry does not diminish. The production of tears is a necessary part of growing old. Crying provides validation, and confirmation, that our lives are filled with love. And with sadness. Love and sadness are interwined. If we did not know love, we would never feel sad. And if we did not know grief, we would never experience the magic of love. As we get older, the connection between love and loss grows deeper and tighter.

And so the tearfall of the old is a necessary part of coming to terms with life, helping us understand our past and accept our future.

Doesn’t it make sense to see our lacrimal glands as vital organs?

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