[18], [19] In previous studies we found atypical bacteria on the ocular surface of patients with overt inflammation [20] and demonstrated that increased bacterial flora was associated with reduced conjunctival goblet cell density, a marker of dry eye syndrome and ocular surface inflammation. [17] We also found altered levels of goblet cell mucin secretion in severe dry eye patients. [21] It was therefore of interest to investigate the role of goblet cells in regulating inflammation that can be induced by bacteria. The gene discussed is MUC5AC; the disease is dry eye syndrome.