Any value less than 5 mm is abnormally low. Conjunctival and lacrimal gland biopsies may be of value to identify the underlying histopathologic findings. Conjunctiva biopsy specimens reveal hydropic epithelial degeneration. Lacrimal gland biopsies may reveal neuronal degeneration and depletion of dense core vesicles. Artificial tears are used as the primary treatment modality as often as necessary to relieve ocular discomfort.
Severe cases necessitate more viscous preparations such as gels and ointments.
Pay particular attention to preservatives and concomitant hypersensitivity. Petrolatum gels may be used at night. Progressive symptoms may require sustained-release ocular inserts. Moisture chambers at night may be attempted, but compliance in children is often poor. Blepharoconjunctivitis may be treated with hot compresses and the addition of antibiotic drops or ointments.