“…In blood the interactions between erythrocytes are key in this behaviour whereas in synovial fluid it is hyaluronic acid existing as long chain anisotropic molecules that change the rheology of the fluid. 4 If it is tricky being a tear drop, it is equally vexatious being a designer of a tear replacement drop. The very fact that we have so many from which to choose, carboxymethylcellulose, hydroxymethylcellulose, carbomer gel, hyaluronic acid, 5 propylene glycol/ hydroxypropyl-guar, 6 and lipid emulsion 7 among artificial lacrimomimetics 8 in products ranging through Actimist, Advance Eye Relief, Akorn, Akwa, Blink, Clarymist, Clear Eyes, Freshkote, GenTeal, Hylogel, Isopto, Just Tears, Lacril, Lacrisert, Liposic, Lubrifresh, Murine Tears, Natural Balance, Nature's Tears, Nutratear, Oasis Tears, Paralube, Refresh, Rohto Hydra, Systane, Soothe, Tearisol, Tears Again, Tears Natural, Thera Tears, Ultra Tears, Visco Tears, and Vizulize Dry Eye Mist and even good old fashioned Lacrilube with products such as lanolin from sheep wool, 9 not to forget of saliva in submandibular gland transplantation in human patients 10 or parotid duct transposition in the dog, 11 suggests that none is 100% effective in every patient.…”