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alacrima
Lacrimal gland secretory disorder, generally congenital
Etiology:
- isolated congenital alacrima
- Riley-Day syndrome
- anhydrotic ectodermal dysplasia
- Sjogren's syndrome
- AAA syndrome
Pathology:
- optic atrophy
Epidemiology: uncommon
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)
Special laboratory:
- 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
Related
dry eyes; xerophthalmia; keratitis sicca; keratoconjunctivitis sicca
General
congenital anomaly (birth defect)
References
http://www.emedicine.com