What is Aqueous Deficient Dry Eye (ADDE)?

• A. Decreased aqueous tear production from lacrimal gland dysfunction
• B. Increased tear production due to lacrimal overactivity
• C. Obstruction of meibomian glands
• D. Inflammation of conjunctiva without tear deficiency

Answer: (A)

Aqueous Deficient Dry Eye is defined by a reduced production of the aqueous component of the tear film, usually from lacrimal gland dysfunction. When the lacrimal glands don’t produce enough aqueous tear, the overall tear volume on the ocular surface falls, leading to lubrication problems, surface drying, and irritation. This explains why dryness is due to lack of tear production rather than just tear loss. In contrast, dry eye can also arise from evaporative causes, where the tear film evaporates too quickly because the lipid layer (from the meibomian glands) is deficient or dysfunctional; that’s not about producing fewer tears but about losing them faster. Statements describing increased tear production would not cause dryness, and obstruction of the meibomian glands points to evaporative, not aqueous-deficient, dry eye. Similarly, inflammation of the conjunctiva without a tear deficiency doesn’t capture the core issue of ADDE, which is insufficient tear volume from the lacrimal glands.