alacrima alacrima alacrima refers to an abnormality in tear production that could mean reduced tear production or absent tear production. because a lack of tears presents in only in a few rare disorders, it aids in diagnosis of these disorders, including triple-a syndrome and ngly1 deficiency. alacrimaspecialtyophthalmologydifferential diagnosistriple-a syndrome alacrima can be formally diagnosed through a schirmer's test.