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Alacrima presenting in the third decade

2005; Elsevier BV; Volume: 40; Issue: 1 Linguagem: Inglês

10.1016/s0008-4182(05)80124-3

1715-3360

Abdul Al-Muammar, William Hodge, Steven Gilberg,

Ocular Surface and Contact Lens

Aqueous tear deficiency can occur as a congenital or acquired process. Alacrima (lacrimal gland hypoplasia) refers to a wide spectrum of lacrimal secretory disorders that are usually congenital. Symptoms can range from complete absence of tears to hyposecretion of tears; rare presentations include those where there is a selective absence of tearing in response to emotional stimulation but a normal secretory response to mechanical stimulation. Alacrima has been reported as an isolated congenital finding in a healthy child with no family history of lacrimal secretory disorders.1 It may be inherited, with numerous Mendelian genetic presentations,2–4 or may be part of ocular or systemic syndromes.5 The developmental mechanism of alacrima is not clear. Possible theories are lacrimal (superior salivary) nuclear aplasia, failure of central or peripheral nervous system innervation,6 persistence of physiologic alacrima of the newborn1 or primary lacrimal gland aplasia/ hypoplasia.2 Acquired causes of aqueous tear deficiency may result from autoimmune conditions, radiation, metastatic and nonmetastatic infiltrative processes of the lacrimal gland, infections, injury and medical therapy. We describe a young adult who presented with unilateral lacrimal gland hypoplasia.