Lacrimal gland disorders

Epidermal keratinization and mucous membrane squamous metaplasia respond to both oral and topical vitamin A therapy. Vitamin A exists in three forms retinol, retinal, and retinoic acid.VitaminA increases the mucous production of goblet cells and perhaps the aqueous and lipid components of the tears as well. Tretinoin is a normal metabolite and the carboxylic form of retinol. Retinol is present in tears and the lacrimal gland appears to be its major provider. Retinoic acid has been shown to be effective in ocular surfece disorders such as squamous metaplasia by reversing the corneal and conjunctival keratinization and improving epithelium wound healing rate. 

Lack of aqueous production at birth is a disorder termed congenital alacrima. This rare condition may result from hypoplasia of lacrimal gland tissue or congenital paralysis of cranial nerves. Another congenital and equally rare cause of aqueous deficiency is familial dysau-tonomia (Riley-Day syndrome), a disorder associated with a short life span. 

RA is a crippling potentially lethal disease that affects connective tissue and the vascular system throughout the body. It affects the eye in a variety of ways, notably through autoimmime damage to the lacrimal gland and with resultant dry eye syndrome. Indeed, Sjogren s syndrome and KCS are common threads that tie these disorders together. 

Sjogren s syndrome an autoimmune disorder affecting the salivary and lacrimal glands. In this disorder, immune cells attack host exocrine glands that are responsible for the production of tears and saliva. 

The frequency of ocular involvement in sarcoidosis ranges between 10% and 50% in American and European studies (1). In these reports, extraocular disorders such as lacrimal gland involvement and sicca syndrome were included (1). Ocular sarcoidosis seems to be more common in the Japanese where eye involvement has been reported in 64% to 89% of sarcoidosis patients (1). In the United States, ocular sarcoidosis is more common in African Americans than Caucasians (2,3). The low rates of eye involvement with sarcoidosis in some series may be because of the lack of thoroughness in examination of the eye (1). 

Potassium Iodide. When potassium iodide [7681-11-0] is adrninistered orally for several (6—8) weeks, a therapeutic effect may be obtained ia the subcutaneous form of sporotrichosis. Amphotericin B is used iatravenously to treat systemic sporotrichosis. The KI dosage is usually a saturated solution ia water (1 g/mL). The usual oral dose is 30 mg/kg/d. Children should receive five droplets, three times a day (after meals) the dose may be iacreased to 15—20 droplets. Side effects iaclude digestive disorders, swelling of the saUvary glands, and lacrimation. Thyroid function tests may be disturbed. 

---