Swati Singh

Lacrimal gland (LG) choristomas are ectopically located lacrimal gland tissue that present as mass lesions, and their diagnosis is confirmed by histopathology. The current study reviews cases of lacrimal gland choristoma published between 2016 and 2025 and reports a rare case of bilateral epibulbar lacrimal gland choristoma associated with a limbal dermoid and ocular colobomatous anomalies in a young female. LG choristomas have been reported in the conjunctiva, eyelid, orbit, lacrimal drainage system, and intraocular structures. They can be simple or have associated syndromic presentations such as Goldenhar syndrome, linear nevus sebaceous syndrome, epidermal nevus syndrome, and craniofacial microsomia. Molecular studies in syndromic cases demonstrated postzygotic somatic mutations in HRAS, KRAS, and NRAS, affecting the RAS-MAPK signaling pathway. Histopathology demonstrated mature lacrimal gland acini and ductal structures within fibrofatty stroma. Whole-exome sequencing did not identify pathogenic mutations associated with choristoma syndromes, ectodermal dysgenesis, or neuroectodermal developmental disorders.

Sjögren’s disease (SjD) is a chronic autoimmune disorder that primarily affects the exocrine glands, particularly the salivary and lacrimal glands, with a worldwide prevalence estimated at 0. 01% t...

Purpose: To predict the diagnostic value of the fluorescein-assisted labial salivary gland test (FAST) in diagnosing Sjögren disease (SjD) and its correlation with biopsy positivity. Methods: Consecutive patients presenting with aqueous-deficient dry eye, that is, dry eye symptoms plus Schirmer less than 10 mm in 1 eye and positive ocular staining, were investigated for SjD using serology and labial minor salivary gland (MSG) biopsy. Using the FAST technique, the number of actively secreting MSGs and the flow rate were calculated in μL/min. Receiver operating characteristic curves, sensitivity, and specificity were calculated. Results: Of 43 patients with aqueous-deficient dry eye, 23 (56.6%) had a focus score greater than 1, and 2 were seropositive for SS-A or SS-B. Twenty-seven (62.8%) reported dry mouth, of which only 14 were biopsy-positive. The median gland number and mean MSG flow rate were 11 (interquartile range, 11) 0.81 ± 0.8 μL/min in biopsy-positive cases, and 18.5 (8) 1.4 ± 0.9 μL/min in biopsy-negative cases, respectively. Receiver operating characteristic analysis demonstrated that both flow and gland number were associated with biopsy positivity. Flow showed moderate diagnostic performance (area under curve (AUC) = 0.68), with an optimal cutoff of <1.21 μL/min yielding 73.9% sensitivity and 73.7% specificity. Gland number demonstrated better discrimination (AUC = 0.73), with a cutoff of <14.5 providing 69.6% sensitivity and 78.9% specificity. There was a moderately positive correlation between the glandular area observed on histology and gland number and flow. Conclusions: FAST can assist in identifying the labial biopsy site containing confluent, actively secreting glands, especially near the lip commissures, and in increasing the glandular area captured on histology in suspected SjD patients.

The current meta-analysis reviewed the dry eye symptomatology and tear film differences between PCOS and healthy women. PubMed, Cochrane Library, and Scopus were searched for prospective/cross-sectional studies on patients with PCOS where at least one tear film parameter or dry eye symptomatology had been tested and compared with healthy controls. The analyzed data were changes in ocular surface disease index scores (OSDI), tear film break-up time (TBUT), Schirmer values, and Meibography. RevMan software was used for meta-analysis, and weighted mean differences (MD) were computed along with GRADE evidence level determination. Thirteen articles were included, and PCOS (n = 639) was diagnosed using the Amsterdam (n = 2) or Rotterdam (n = 11) criteria. Studies were heterogeneous (I² > 75%) for all analyzed parameters. OSDI (MD 7.5, 95% CI 1.4 to 13.6, p = 0.02) and invasive TBUT (MD -3.1s, 95% CI -4.7 to -1.6, p < 0.0001) were worse in PCOS whereas Schirmer I (MD -1.8, 95% CI -4.5 to 0.5, p = 0.12) and noninvasive TBUT (MD -2.1, 95% CI -4.2 to -0.03, p = 0.05) were similar between PCOS and healthy controls. Forest plots revealed an overall MD estimate of all parameters to lie close to the null effect line. All studies had a low level of certainty regarding evidence. Women with PCOS can experience mild dry eye symptoms; however, tear volume and tear film stability are similar in women with PCOS and those without the condition. In most studies, tear film parameters of PCOS women do not meet DEWS II criteria for DED diagnosis, though they are heterogeneous and have low levels of certainty.

Purpose: To study the characteristics of dry eye disease (DED) secondary to ocular or systemic infections. Methods: PubMed, Scopus, and Cochrane databases were systematically reviewed for DED development after systemic and ocular infections. The severity of DED symptoms and signs, type of infection, and management outcomes were analyzed. Results: Of the 28 included studies, eight were related to HIV infection, five had hepatitis C, four to COVID-19, and 11 studies had DED secondary to herpes keratitis, Mycoplasma pneumoniae , viral conjunctivitis, Chlamydia infection, Mycobacterium leprae , and Chikungunya infections. The organisms implicated in conjunctivitis associated with DED were Coxsackie A24virus, S taphylococcus , and Mycoplasma . There were no immunocompromised patients in any of the studies except HIV. Nine studies established DED diagnosis based on symptoms alone, seven on signs alone, and 12 on symptoms and signs (at least abnormal Schirmer or tear break-up time, but not DEWS II criteria). The severity of DED symptoms was usually mild. HIV and hepatitis C showed no difference in tear volume and stability between cases and healthy controls. Advanced stages of hepatitis (stage 4 to stage 6) showed worse tear film parameters than the initial stages. Tear volume and stability were affected in 1/5 ^th of patients post-COVID-19. Absolute tear deficiency (zero Schirmer) was reported in two patients after Epstein–Barr virus and HIV infection that improved with intravenous acyclovir, cyclosporin A, and prednisolone in EBV infection only. Very few studies reported the management of postinfectious DED with artificial tears and had fair outcomes. Conclusion: Bacterial and viral infections can have DED as sequelae, although the infectious agent has not been isolated from the ocular surface in reported studies. DED is usually mild to moderate symptomatically, and tear film parameter levels do not meet DEWS II diagnostic criteria. The nonuniformity in reporting disease duration, tear film changes, and DED symptoms makes it difficult to understand the role of infection in causing DED.