alacrima

Introduction

Lacrimal gland secretory disorder, generally congenital

Etiology

• isolated congenital alacrima
• Riley-Day syndrome
• anhydrotic ectodermal dysplasia
• Sjogren's syndrome
• AAA syndrome

Epidemiology

uncommon

Pathology

• optic atrophy

Clinical manifestations

• congenital disorder
• variable, complete absence to hyposecretion of tears
• may be selective absence of secretion to emotional stress, but normal secretion of tears to mechanical stimulation
• may be asymptomatic
• foreign body senstation
• photophobia
• ocular pain
• decreased visual acuity
• chronic blepharitis, chronic conjunctivitis
• palsies of CN 3, CN 4, CN 6
• anisocoria
• systemic findings (see AAA syndrome)

Diagnostic procedures

• Schirmer tear test

Radiology

• CT of the orbits shows aplastic/hypoplastic lacrimal ducts

Management

• artificial teats
• more viscous preparations may be necessary in severe cases
  • ointments
• antibiotics drops or ointments for blepharitis, conjunctivitis

More general terms

• congenital anomaly (birth defect)

Additional terms

• dry eyes; xerophthalmia; keratitis sicca; keratoconjunctivitis sicca