ALTHOUGH congenital absence of tears is a rare defect, its existence has been known since Thurnam's1 report of two cases in 1848. Under the title of alacrimia congenita Sjögren and Eriksen,2 in 1950, discussed this subject, and in 1952 Sjögren3 reviewed 14 of the cases reported in the ophthalmic literature without establishing a common etiologic factor. Among the ascribed causes were (1) persistence of the physiologic condition of the newborn, (2) hypoplasia or absence of the lacrimal gland, and (3) disturbance of innervation of the lacrimal gland. In addition to the previously reported cases, there is a condition in which congenital alacrima is a constant finding. Credit for the recognition of this clinical entity goes to Riley4 and his co-workers, who in 1949 reported five such cases under the title of "Central Autonomic Dysfunction with Defective Lacrimation." Largely as the result of subsequent studies by Riley,
DUNNINGTON JH. CONGENITAL ALACRIMA IN FAMILIAL AUTONOMIC DYSFUNCTION. AMA Arch Ophthalmol. 1954;52(6):925–931. doi:10.1001/archopht.1954.00920050931012
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