Which of the following is NOT listed as a cause of Aqueous Deficient Dry Eye?

• A. Immune-mediated
• B. Bacterial keratitis
• C. Hypothyroidism
• D. Distemper (infectious)

Answer: (B)

Aqueous Deficient Dry Eye happens when tear production from the lacrimal glands is reduced, leading to a deficient aqueous layer on the ocular surface. In dogs, immune-mediated destruction of the lacrimal glands is a common cause, and systemic diseases like hypothyroidism can contribute to decreased tear production. Distemper infection has also been associated with lacrimal gland dysfunction and dry eye in the past. Bacterial keratitis, by contrast, is an infectious process of the cornea that mainly causes corneal ulcers and surface inflammation; it does not represent a primary lacrimal gland failure and is not listed as a cause of aqueous-deficient dry eye.