Sjögren's (prounounced “SHOW-grins”) syndrome is an autoimmune disease, where the body’s white blood cells attack healthy tissue and organs. With this disease, the immune system attacks the glands that keep our eyes and mouth lubricated. This is why dry eyes are very common with Sjögren's syndrome.
Sjögren's syndrome is a common autoimmune disease, and it may sometimes be detected during a comprehensive eye exam. Nine out of 10 people who have it are women between 40 and 60 years old. However, it can affect men and women of any age or race.
Symptoms of Sjögren's syndrome
Eye-related symptoms of Sjögren's syndrome include:
Other common symptoms include dry mouth and pain in your joints.
Diagnosis
Your ophthalmologist may do one or more of tests:
- Schirmer’s test. This is where a tiny strip of paper is placed under your lower eyelid to measure the amount of tears your eye makes over a period of about five minutes.
- A dye test may be used to color your tears. This allows your doctor to see with a microscope how quickly your tears dry up. It can also help your eye doctor see how dryness has affected your cornea or other parts of the eye.
- Eyelid exam. Your eye doctor might examine the meibomian ("my-BOH-me-un") glands in your eyelids to see if they are working correctly. These produce oil for your tears to help keep them from drying out too quickly. If these glands are swollen or blocked, your tears may not have the right amount or quality of oil. This is one cause of dry eye.
- Saliva exam. They may measure how much saliva you
have in your mouth.
- Labial gland biopsy to examine the tissue in your lip.
- Blood tests to check for certain proteins called antibodies and other blood markers usually found in people with Sjögren’s syndrome.
If needed, your ophthalmologist may refer you to a rheumatologist, a doctor who specializes in autoimmune disease. The rheumatologist will review the blood tests, and may help with treatment.
Treatment
It is important to treat the ongoing dry eye of Sjögren's syndrome. Otherwise, your eyes will remain irritated and very uncomfortable. In rare cases, they can become infected and scarred, affecting your vision.
Your eye doctor may recommend you use lubricating eye drops or ointments. These drops are important in keeping your tears from drying out too quickly. That way your eyes will stay moist longer.
There are other eye drop medicines your doctor may prescribe. In some cases, drugs to treat autoimmune disorders may also be prescribed that will help improve the dryness.
If you have a problem with your meibomian glands (called meibomian gland dysfunction, or MGD), your doctor will treat this. Treating MGD will help your tears function properly.
To can help keep your eyes moist by:
- remembering to drink plenty of water
- using artificial tears and ointments as often as your eye doctor recommends
- using a humidifier in your home if the air is very dry
- telling your eye doctor about any medicines you are taking (including allergy medicine), as they may cause dryness