What is the main treatment in ADDE?

• A. Immunomodulation
• B. Heat therapy
• C. Antibiotics
• D. Lipid replacement

Answer: (A)

ADDE involves reduced lacrimal tear production due to immune-mediated damage to the lacrimal glands. The most important treatment is immunomodulation because it targets the underlying disease process, aiming to dampen the T-cell–driven inflammation that lowers tear production. Medications such as topical cyclosporine ( or tacrolimus) are used to reduce glandular inflammation and improve tear production over time, and sometimes systemic therapy is needed for associated autoimmune conditions. While lubricants and artificial tears help with symptoms, they don’t stop the ongoing immune attack or restore tear production as effectively as immunomodulatory therapy. Antibiotics, heat therapy, or lipid replacement may provide supportive benefits in specific scenarios, but they are not the main approach for addressing the primary defect in ADDE.