Severe dry eye due to isolated bilateral lacrimal gland agenesis in a child. A challenging case report and review of the literature

Abstract

We present a challenging case of severe dry eye secondary to alacrimia due to bilateral lacrimal gland agenesis (LGA) in a child and its successful treatment. A 7-year-old girl presented with symptoms and findings of severe dry eye and keratitis. Systemic associations were excluded, and orbit imaging demonstrated bilateral LGA. Treatment with punctal occlusion, blood-derived and preservative-free eye drops, and PROSE® system/scleral contact lens proved an excellent clinical result. Lacrimal gland hypoplasia is a rare cause of severe dry eye in children. Prompt diagnosis and integral treatment are crucial to reverse ocular surface damage and allow patients to return to their daily activities.