Understanding Xerophthalmia and its Causes, Symptoms, and Treatment

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Xerophthalmia is an ocular disease in which the eye undergoes structural changes due to lack of tears. The most common or generic term for this is “dry eye.” It can occur either as a primary condition or as a condition secondary to another disease. Xerophthalmia is definitively a chronic condition that can produce severe eye damage if left untreated.

Primary Xerophthalmia

In primary xerophthalmia, dryness to the eyes occurs after damage to the tear glands and/or tear ducts. This can be caused by some physical trauma such as being hit in the eye. “Dry eye” can also occur if the eyes become infected. This causes damage to the glands that moisten the eyes and produce tears. An infection in the tear ducts is also possible.

Secondary Xerophthalmia

In secondary xerophthalmia, lack of moisture or tears occurs as a secondary sign or symptom to another medical condition. One common secondary cause of having “dry eye” is vitamin A deficiency. One of the main functions of vitamin A is to produce and maintain normal vision, especially when there is a reduction in the amount of light. Vitamin A is used to manufacture the visual pigment located in the retina.

Another cause for secondary xerophthalmia is Sjogren’s syndrome. In this disease, the body produces T cell lymphocytes against the cells of the tear and salivary glands. As the tear glands become infiltrated with T lymphocytes, the normal gland and duct cells are destroyed.


The symptoms of xerophthalmia are simple but will vary slightly depending if it is of a primary or secondary cause. Overall there will be widespread dryness of the conjunctiva and in severe cases, conjunctival ulcers leading to erosion. There are also formations of opaque spots in certain sections; these are known as “Bitot spots.” In secondary cases of xerophthalmia, the cornea may erode with accompanying night blindness as in the case of vitamin A deficiency.


The treatment of this condition will depend on if it has a primary or secondary cause. The doctor can prescribe artificial tears and eye lubricants in all cases, or in more severe instances, the duct that drains away moisture from the eyes can be permanently closed with surgery.


Print Source: Davidson, Stanley & C. Haslett. 2002. “Davidson’s Principles and Practice of Medicine.” Churchill Livingstone, Edinburgh.

Print Source: Kumar V, Ramzi C, and T. Collins. 1999. “Robbins Pathologic Basis of Disease.” 6th ed. WB Saunders Company, Philadelphia.