What you need to know about aqueous tear deficient dry eye disease


What is aqueous tear deficient dry eye disease?

Your tears do much more than indicate that you are crying. They have other functions. The tear glands supply your eyes with the tears required to keep them moist. Each time you blink, they supply the tears needed. Those tears keep your eyes moist, clean, and healthy. If your tear glands stop this supply for any reason, it can lead to the condition called aqueous tear deficient dry eye disease. This condition usually comes with vision problems, redness of the eyes, and eye discomfort or pain.

Causes of aqueous tear deficient dry eye disease

Many factors can cause or contribute to aqueous deficient dry eye disease but the two most common ones include Sjogren’s syndrome and advanced age. 

Sjogren’s syndrome

Sjogren’s syndrome is a disease that attacks both tear glands and saliva glands. Tear glands will no longer be able to produce tears and the glands that secrete your spit will also stop functioning. So, those who have the disease will usually have both aqueous tear deficient dry eye disease and dry mouth disease.

It has also been observed that women are more prone to Sjogren’s syndrome than men. The fact that about 10 percent of people with dry eye disease also have Sjogren’s syndrome underscores the strong link between both conditions.


Just like most body parts, the tear glands function less as you grow older. Besides, since your immune system will also naturally get weaker with age, your chances of getting Sjogren’s syndrome, aqueous tear deficient dry eye disease, or any other disease, will become higher as you grow older.

 Other conditions causing aqueous tear deficient dry eye disease include:

• Damaged tear glands or tear ducts

• Virus infection

• Any of the following diseases can also lead to dry eye disease; Amyloidosis, Hemochromatosis, Sarcoidosis, Lymphoma, and Hepatitis C.

Symptoms include feeling dry and itchy.  You may also find it very uncomfortable to wear contact lenses. In addition, you may have blurred or fluctuating vision. There may be a burning sensation in your eyes. Eye pain and redness of the eyes have also been observed to be common symptoms of the disease. Sometimes, you may feel like there is dirt or sand in your eyes.  A dry eye exam can uncover the underlying cause of such symptoms. 

How to diagnose aqueous tear deficiency? 

The most effective way to diagnose aqueous tear deficient dry eye disease is through a reliable dry eye exam. While there are numerous dry eye tests, the best approach is through a comprehensive assessment using multiple tests including the Oculus Keratograph 5M Meibography and osmolarity.   The Oculus Keratograph 5M is an advanced test that involves the use of both color camera and keratometer for optimized external imaging of the eye. It also includes Meibography which is an imaging study of the morphology of meibomian glands in vivo.

Depending on the findings of your dry eye assessment you optometrist might recommend further testing for  Sjogren’s syndrome.  Depending on the severity of your dry eye disease and the cause, your doctor will determine the best treatment for you.

The standard of care is usually to treating the underlying etiology that’s causing the dry eye condition. Your doctor may also recommend the use of certain lubricating eye drops or supplements. You may also need to use plugs to prevent your tears from draining off. On rare cases, your doctor may suggest a surgery.  It’s best to start with a comprehensive dry eye exam which will first determine the form of the dry eye disease involved.  To book your comprehensive dry eye assessment at our sister clinic please visit their Dry eye clinic page.