Abstract
In Reply. —During visits to other ophthalmic centers in the past, I have been shown several patients with unilateral keratoconjunctivitis sicca demonstrating severe symptoms and signs and very low Schirmer test values but no other disease. In these cases, the lacrimal gland or its ducts had been surgically removed either by mistake or because of tumor. The other eye showed no disease and had a normal Schirmer test. For this reason, Dr Scherz and I thought that it would be reasonable to demonstrate at least one such case in some detail in order to alert our colleagues to the fact that an eye may not tolerate a total loss of the main lacrimal gland. Thus, secretion from only the very small accessory lacrimal glands may not be sufficient to prevent the development of keratoconjunctivitis sicca. The palpebral dacryoadenectomy procedure does not result in dryness in the majority of cases, but
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