LAUSR

The lacrimal sciences have seen several stupendous advances in the past few decades in diagnostics and therapeutic interventions. However, the same cannot be claimed for the disease etiopathogenesis. Understanding the lacrimal disease mechanisms and their molecular pathogenesis is the next logical step to advance the science. In this context, the concept of “Lacriome” is being introduced by the author as an umbrella term that defines the collective microenvironments of the lacrimal system. The lacrimal microenvironment is a small yet distinct biophysical environment integral to the structure and functions. This includes a variety of cellular and molecular profiles, secreted factors, extracellular proteins, metabolic by-products, and exogenous agents. Several interactions in the lacrimal microenvironments can contribute to the disease pathogenesis. For example, soluble glycoproteins, hormonal microenvironments, and tear microenvironments are suspects in the etiopathogenesis of primary acquired nasolacrimal duct obstruction [1–3]. The broad constituents of a “Lacriome” include the lacrimal microbiome, metagenome, lacrimal metabolome, lacrimal glycome and lipidome, lacrimal epigenome and genome, lacrimal proteome, and transcriptome. The constituents by no means are exhaustive, and several more can be added as our understanding progresses. All these “omes” can be studied with specific techniques called “omics,” for example, metagenomics, proteomics, lipidomics, genomics, glycomics, and transcriptomics, or a variable combination of them called “multi-omics.” The methodologies of several “omics” have significantly evolved and can be applied to the lacrimal system. It is important to have an umbrella term “Lacriome” to integrate the various molecular processes of the lacrimal system and to study their interactions with each other within the specific lacrimal ecosystem. This would enable studies of each lacrimal disease from a holistic perspective and a better understanding of the pathophysiology as a whole.