Which condition is associated with inflammatory infiltration of the lacrimal gland leading to aqueous tear deficiency?

• A. Rheumatoid arthritis
• B. Sarcoidosis
• C. Sjogren's syndrome
• D. Nocturnal lagophthalmos

Answer: (B)

Inflammatory infiltration of the lacrimal gland leading to reduced tear production happens most characteristically in Sjogren's syndrome. This autoimmune exocrinopathy causes lymphocytes to invade the lacrimal glands, damaging the secretory tissue and leading to aqueous tear deficiency. Patients typically experience dry eye symptoms such as a gritty sensation, and tear production is measurably reduced on testing (Schirmer test). Sjogren's often coexists with other autoimmune features, and can be seen with rheumatoid arthritis, but the lacrimal gland destruction that causes dry eye is the hallmark of Sjogren's.

While sarcoidosis can involve the lacrimal gland and cause dry eye from granulomatous infiltration, it is not the classic cause of aqueous tear deficiency. Nocturnal lagophthalmos is an eyelid closure issue leading to exposure-related dryness, not from inflammatory lacrimal gland destruction.