Sjogren’s Syndrome is a systemic autoimmune disease which attacks and destroys the glands that keep the eyes and the mouth moist, resulting in dry eye and dry mouth. Other common symptoms are fatigue, joint and muscle pain, brain fog, and trouble sleeping. The typical Sjogren’s patient is a female over the age of forty, but this is not a hard and fast rule. As an optometrist, I am often the first health care provider to suspect Sjogren’s, especially in patients whose dry eye keeps worsening or does not respond to traditional dry eye treatment. When I have a patient who has moderate or severe dry eye I will always ask about dry mouth or dental problems as well as joint pain. A definitive Sjogren’s diagnosis can sometimes be elusive – blood work for serological markers can sometimes yield both false positives as well as false negatives. The next step would be a biopsy of the minor salivary gland to test for cellular infiltration but this too is not always definitive. Unfortunately there is no cure for Sjogren’s syndrome but a consult with a rheumatologist will help patients treat symptoms and prevent future complications with medications such as immunosuppressants, nonsteroidal anti-inflammatory drugs and other arthritis medications.
The treatment of dry eye due to Sjogren’s syndrome depends on the severity of the dry eye. A combination of over the counter artificial tears and ointments as well as prescription eye drops are the mainstay of treatment. Hot compresses with eyelid massage as well as special eyelid cleansers are other options that are available. Since Sjogren’s syndrome is a chronic illness patients sometimes needs to be seen a couple of times a year to ensure that the dry eye is well controlled. Untreated dry eye can lead to blurred vision, infections, eye inflammation and corneal abrasions.
For more information check out www.sjogrens.org
Chani Miller, OD