A reduced tear flow may produce keratoconjunctivitis sicca. When this occurs with xerostomia (dry mouth) it comprises Sjogren’s syndrome which is usually associated with one of a variety of systemic disorders, particularly rheumatoid arthritis. Patients with keratoconjunctivitis sicca usually present with non-specific symptoms, such as soreness, grittiness or a feeling of a foreign body in the eye, and the lack of tears may be overlooked.
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