Sjögren’s Syndrome- Causes, Symptoms, Diagnosis & Treatment

Including concentration/memory loss, “brain fog”, dysautonomia, peripheral neuropathy, Raynaud’s syndrome and headaches.

Dry eyes, corneal ulcerations and infections. Preservative-free eye drops and sprays can help with these symptoms.

Including a dry nose, recurrent sinusitis and nosebleeds.

A dry mouth with mouth sores, dental decay, difficulty chewing, speech, and dentures. Swollen, painful parotid and salivary glands. Difficulty swallowing, heartburn, reflux and oesophagitis.

Recurrent bronchitis, interstitial lung disease, and pneumonia.

Joint and muscle pain, including arthritis.

Abnormal liver function tests, chronic active autoimmune hepatitis and primary biliary cholangitis.

Stomach upset, gastroparesis, irritable bowel, autoimmune gastrointestinal dysmotility.

Interstitial cystitis, interstitial nephritis including renal tubular acidosis, glomerulonephritis, and autoimmune pancreatitis. Vaginal dryness, vulvodynia, chronic prostatitis, autoimmune pancreatitis, fatigue, vasculitis, lymphoma, dry skin and skin sensitivity to UV light.

Sjögren’s Syndrome is an autoimmune disease primarily affecting the body’s moisture-producing glands, including the tear and salivary glands. According to estimates, over 90% of people with Sjögren’s Syndrome suffer from dry eyes, making it one of the most prevalent and noticeable symptoms associated with the disorder. It is quite common for individuals with Sjögren’s Syndrome to experience dry eyes. In fact, dry eyes and mouth are this condition’s hallmark symptoms.

The primary eye-related symptom of Sjögren’s Syndrome is dry eyes, known as keratoconjunctivitis sicca. This condition is characterized by reduced tear production and can lead to various other symptoms, such as:

• A gritty, sandy, or burning sensation in the eyes
• Itching or redness
• Blurred vision
• Sensitivity to light
• Eye fatigue
• Excessive tearing, often as a reflex to eye irritation
• Feeling like there’s a foreign object /something in your eyes

Tears play a crucial role in maintaining the health and comfort of the eyes, as they lubricate the ocular surface, remove debris, and help prevent infection. Sjögren’s Syndrome affects the eyes by attacking the lacrimal glands responsible for producing tears. When the immune system mistakenly targets these glands, they become inflamed, reducing tear production. Insufficient tear production disrupts the delicate balance of the eye, causing discomfort and increasing the risk of eye complications.

Several treatment options are available to manage dry eyes caused by Sjögren’s Syndrome. These may include:

• Artificial tears: Over-the-counter lubricating, preservative-free eye drops & sprays can temporarily relieve dry eye symptoms by supplementing natural tear production.
• Prescription eye drops: Medications such as cyclosporine (Restasis) or lifitegrast (Xiidra) can help increase tear production in some individuals.
• Punctal plugs: Sometimes, a doctor may recommend inserting tiny silicone or collagen plugs into the tear ducts to reduce tear drainage and maintain eye moisture.
• Warm compresses & eyelid hygiene: Regularly applying warm compresses and cleaning the eyelids can help alleviate dry eye symptoms and reduce inflammation.
• Humidifiers: Using a humidifier to add moisture to the air may relieve dry eye discomfort, especially in dry environments.
• Omega-3 fatty acid supplements: Studies suggest that omega-3 fatty acids may help improve dry eye symptoms in some people with Sjögren’s Syndrome.

While Sjögren’s Syndrome primarily causes discomfort and irritation in the eyes, it can potentially lead to more severe complications if left untreated. Chronic dry eyes can cause the eye’s surface to become more vulnerable to infections and abrasions. In severe cases, untreated, dry eye may result in corneal damage or even vision loss. Therefore, it is crucial to seek appropriate medical care and closely follow the treatment plan provided by your eye specialist.

Diagnosing Sjögren’s Syndrome-related eye problems usually involves a comprehensive eye exam by an ophthalmologist or optometrist in conjunction with a patient’s medical history, symptoms, and other diagnostic tests. Some of the tests include:

• Schirmer’s test: This test measures tear production by placing a small strip of filter paper under the lower eyelid for a specific period. The amount of moisture absorbed by the paper indicates tear production levels.
• Tear Break-Up Time (TBUT): This test assesses tear film stability. A dye is applied to the eye, and the time it takes for the tear film to break up and form dry spots is measured. A shorter tear breakup time indicates poor tear film stability, commonly seen in dry eye conditions. Try our 15-Second Blink Test and test your Tear Break-Up Time (TBUT).
• Corneal and conjunctival staining: Fluorescein or other dyes are used to stain the eye’s surface, allowing the healthcare professional to visualize dry spots, damaged areas, or other abnormalities on the cornea and conjunctiva.
• Meibomian gland assessment: The healthcare professional may examine the eyelids and the function of the meibomian glands, which produce the oily layer of the tear film. Dysfunction of these glands can contribute to dry eye symptoms.
• Ocular surface assessment: A thorough examination of the eye’s surface, including the cornea, conjunctiva, and eyelids, can help identify signs of inflammation, damage, or other issues related to Sjögren’s Syndrome.