secondary lacrimal atrophy

Secondary Lacrimal Atrophy: A Condition Affecting the Lacrimal Gland

Secondary lacrimal atrophy refers to a condition where the lacrimal gland, responsible for producing tears, undergoes atrophy (shrinking) due to various secondary causes. This can lead to decreased tear production and subsequent dry eye symptoms.

Causes of Secondary Lacrimal Atrophy

• Aging: As people age, the lacrimal gland's ability to produce tears decreases, leading to atrophy.
• Diseases: Certain diseases, such as Stevens-Johnson syndrome (SJS), can cause damage to the lacrimal gland and lead to atrophy.
• Infections: Infections in the lacrimal sac or surrounding tissues can also contribute to secondary lacrimal atrophy.
• Trauma: Traumatic injuries to the eye or surrounding areas can cause damage to the lacrimal gland, leading to atrophy.

Symptoms of Secondary Lacrimal Atrophy

• Dry eyes: Decreased tear production leads to dryness and discomfort in the eyes.
• Eye irritation: The lack of tears can cause irritation and redness in the eyes.
• Vision problems: In severe cases, secondary lacrimal atrophy can lead to vision problems due to the decreased tear film.

Diagnosis and Treatment

Diagnosing secondary lacrimal atrophy typically involves a comprehensive eye examination, including imaging tests such as ultrasound or MRI. Treatment options may include:

• Artificial tears: Using artificial tears to supplement the lack of natural tears.
• Lacrimal punctum plugs: Placing small plugs in the tear ducts to prevent excessive tearing and promote healing.
• Surgery: In some cases, surgery may be necessary to repair or remove damaged tissue.

References

[3] Histological examination of 99 human lacrimal glands showed a relationship between atrophy of the secretory acini and secretory duct obstruction. [4] Secondary lacrimal gland atrophy is listed as a disorder in the ICD-9 code 375.14. [8] Chapter 7 - Diseases of the eye and adnexa (H00-H59) » Disorders of eyelid, lacrimal system and orbit (H00-H05) » Secondary lacrimal gland atrophy (H04.15).

Common Signs and Symptoms of Secondary Lacrimal Atrophy

Secondary lacrimal atrophy, also known as secondary lacrimal gland atrophy, is a condition characterized by the degeneration of the lacrimal glands, leading to reduced tear production. The symptoms can vary from person to person but often include:

• Dryness in the eyes: This is the most common symptom, causing discomfort, redness, and itching.
• Gritty or foreign body sensation: Patients may experience a feeling of grittiness or a foreign body sensation in the eye.
• Stinging, burning, or pressure in the eyes: Some individuals may feel stinging, burning, or pressure in their eyes.
• Epiphora (excessive tearing): In some cases, patients may experience excessive tearing due to reflex secretion.
• Photophobia: Sensitive eyes that are irritated by light.
• Blurry vision: Vision may be blurry, which can improve with blinking.

Other associated conditions

Secondary lacrimal atrophy is often linked to other autoimmune diseases, such as:

• Sjögren's syndrome: A chronic autoimmune disease characterized by ocular and oral dryness resulting from lacrimal and salivary gland dysfunction.
• Rheumatoid arthritis: An autoimmune disorder that can cause inflammation in the joints and potentially affect the lacrimal glands.

Important notes

It is essential to consult a healthcare professional for an accurate diagnosis and proper treatment. The symptoms of secondary lacrimal atrophy can be similar to those of other conditions, so a thorough examination and medical history are necessary to determine the correct cause.

References:

• [3] Stinging, burning, or a feeling of pressure in the eyes · A sandy, gritty, or foreign body sensation · Epiphora, or tearing, is a symptom that is ...
• [10] Symptoms of Secondary Lacrimal Gland Atrophy The most common symptom of Secondary Lacrimal Gland Atrophy is dryness in the eyes, which can cause discomfort, redness, and itching.
• [11] Sjögren’s syndrome is a chronic autoimmune disease characterized by ocular and oral dryness resulting from lacrimal and salivary gland dysfunction.

Diagnostic Tests for Secondary Lacrimal Atrophy

Secondary lacrimal atrophy refers to the shrinkage or degeneration of the lacrimal gland due to various underlying conditions, such as obstruction of the secretory ducts. The following diagnostic tests can help identify secondary lacrimal atrophy:

• Histological examination: This test involves examining tissue samples from the lacrimal gland under a microscope. According to [1], histological examination of 99 human lacrimal glands showed a relationship between atrophy of the secretory acini and secretory duct obstruction.
• Nasal endoscopy: This procedure allows for visualization of the nasal cavity, including the maxillary line, middle and inferior meatus, and the valve of Hasner. Lacrimal diseases can be diagnosed through nasal endoscopy by placing focus on these areas [2].
• Corneal topography (keratography): This test may be included in a diagnostic evaluation to assess corneal shape and detect any distortions in vision. According to [3], corneal topography may be particularly useful if a patient reports distortion of vision.
• Vital dyes and Schirmer tests: These tests can provide valuable information for an accurate diagnosis by assessing tear production and drainage. Using vital dyes and conducting tests such as Schirmer and Jones can provide valuable information for an accurate diagnosis [4].
• Angiotensin converting enzyme (ACE) level, lysozyme, complete blood count (CBC): These laboratory tests may be ordered to rule out other conditions that could be causing the lacrimal gland atrophy. Other tests commonly ordered for patients with bilateral lacrimal gland disease include an ACE level, lysozyme, CBC [5].
• Impression cytology, Meibography, Tear film interferometry: These tests can help monitor progression of ocular surface changes and assess tear film quality. Impression cytology to monitor progression of ocular surface changes. Meibography. Tear film interferometry [6].

These diagnostic tests can help identify secondary lacrimal atrophy and guide further treatment.

References:

[1] BE Damato (1984) - Histological examination of 99 human lacrimal glands showed a relationship between atrophy of the secretory acini and secretory duct obstruction. [2] Lacrimal diseases can be diagnosed through nasal endoscopy by placing focus on the maxillary line, the middle and inferior meatus, and the valve of Hasner. [3] MS Milner (2017) - Corneal topography may be included as a diagnostic test in a DTS evaluation, particularly if a patient reports distortion of vision. [4] Using vital dyes and conducting tests such as Schirmer and Jones can provide valuable information for an accurate diagnosis. [5] Other tests commonly ordered for patients with bilateral lacrimal gland disease include an ACE level, lysozyme, CBC. [6] Impression cytology to monitor progression of ocular surface changes. Meibography. Tear film interferometry.

Based on the search results, it appears that there are various treatment options for secondary lacrimal gland atrophy.

According to result [10], the lacrimal gland is an exocrine gland similar to the mammary gland and salivary gland. However, when it comes to treating secondary lacrimal gland atrophy, the focus shifts to addressing the underlying causes of the condition.

Result [4] suggests that ambroxol hydrochloride may be a potential treatment option for secondary lacrimal gland atrophy. The study found that a 24-hour treatment with ambroxol hydrochloride upregulated the AQP5 expression, and topical administration of ambroxol increased tear and possibly mucin production.

Additionally, result [3] mentions that ocular treatments for Sjögren's syndrome (SS), which can cause secondary lacrimal gland atrophy, include the use of artificial tears, topical autologous serum, and other symptomatic treatments. However, it does not specifically mention ambroxol hydrochloride as a treatment option.

It is worth noting that result [5] mentions two cases of secondary lacrimal gland atrophy associated with the use of isotretinoin and anabolic androgenic steroids, but it does not provide information on potential treatments for these conditions.

In summary, while there are various treatment options available for secondary lacrimal gland atrophy, ambroxol hydrochloride appears to be a potential treatment option that has shown promise in upregulating AQP5 expression and increasing tear production. However, further research is needed to confirm its effectiveness as a treatment for this condition.

• Ambroxol hydrochloride may be a potential treatment option for secondary lacrimal gland atrophy [4].
• Ocular treatments for Sjögren's syndrome include artificial tears, topical autologous serum, and other symptomatic treatments [3].
• Secondary lacrimal gland atrophy can be caused by various factors, including isotretinoin and anabolic androgenic steroids [5].

Based on the provided context, it appears that differential diagnosis for secondary lacrimal gland atrophy involves several conditions and factors.

Possible Causes

• Isotretinoin use [1][2]
• Androgen-related issues [1][2]
• Prolactin-related problems [1][2]
• Sjögren's syndrome [1][4]

Other Differential Diagnoses

• Infection
• Systemic inflammatory conditions
• Neoplasms (e.g., lymphoma) [3]
• Dacryoadenitis
• Lacrimal gland ductal cysts
• Foreign body granulomas
• Lymphoma [5]

Clinical Manifestations and Differential Diagnosis

The clinical manifestation of lacrimal gland atrophy can include painless swelling around one or both eyes, which is a common presentation in patients with IgG4-related disease [6].

Histological Examination

A histological examination of the lacrimal gland has revealed acinar dilation, interstitial fibrosis, with inflammatory aggregates and atrophy with fibrosis [7].

Differential Diagnosis of Sjögren's Syndrome

The differential diagnosis of Sjögren's syndrome includes conditions that can produce keratoconjunctivitis sicca, xerostomia, and parotid gland enlargement [8].

Lacrimal Gland Masses

Approximately 50% of lacrimal gland masses are inflammatory lesions, 25% are lymphoid lesions or lymphoma, and the other 25% are salivary gland type tumors [9].

Note: The above information is based on the provided context and may not be an exhaustive list of differential diagnoses for secondary lacrimal atrophy.