Sjogren's Syndrome and Chronic Dry Eye
Reviewed by: HU Medical Review Board
Sjögren’s (“SHOW-grens”) syndrome is an autoimmune disorder where the body attacks its own glands that make tears and saliva. This causes dry eyes and dry mouth.1
Many people who develop Sjögren’s syndrome have other autoimmune disorders or diseases, such as rheumatoid arthritis (RA) or lupus. This is known as having a comorbid condition. Doctors use the term comorbidity to describe a condition or illness that occurs at the same time as another condition or illness. Comorbid illnesses can interact in ways that worsen both. Morbidity should not be confused with the term mortality. Morbidity means disease or illness, and mortality means death.1-3
Whether you have been diagnosed with Sjögren’s syndrome or you suspect you may have it, you likely have some unanswered questions. Knowing what Sjögren's syndrome is, who gets it, how it is related to chronic dry eye, and the various treatments and outcomes will help you learn to manage this condition.
What is Sjögren’s syndrome?
Your immune system is designed to keep you healthy and protect you from infection and disease. If you have an autoimmune disorder, your body does not recognize the difference between healthy and harmful substances, so it begins to attack its healthy cells by mistake. Doctors do not know the exact reason why autoimmune disorders occur.4
Sjögren’s syndrome is an autoimmune disorder that affects the moisture-producing glands of the body. Sjögren’s syndrome most commonly impacts the glands that produce tears (lacrimal glands) and saliva (salivary glands).5
Dryness from Sjögren’s syndrome may also affect other areas of the body that need moisture, like the nose, throat, skin, or vagina. Rarely, Sjögren’s syndrome can affect the liver, kidneys, or lungs.1
Primary Sjögren's syndrome when it occurs on its own, with no other autoimmune conditions present. If a person has it and another autoimmune issue, such as lupus or RA, before developing dryness of the eyes and mouth, it is considered secondary Sjögren's syndrome.2,6
Who gets it?
Between 400,000 and 3.1 million adults have Sjögren’s syndrome. Anyone can have Sjögren’s syndrome, but it affects 10 times as many women as men. Symptoms usually appear between the ages of 45 and 55.2,6
Are my dry eyes caused by Sjögren’s syndrome?
Not all dry eye symptoms are chronic dry eye. Similarly, you can have chronic dry eye and not have Sjögren’s syndrome. Your doctor will be able to diagnose you based on exams, your medical history, and any tests needed.6
Diagnosis, treatments, and outcomes
Sjögren’s syndrome can cause some lab abnormalities, including signs of autoantibodies. These are immune proteins that mistakenly react and attack your own cells. Some autoantibodies can be present under normal circumstances. The types of autoantibodies present in Sjögren’s syndrome can lead to inflammation and damage to the tissues.7
In addition to lab tests, several other tests may be used to diagnose Sjögren’s syndrome-related dry eye:6
- Schirmer's test: Your doctor will place a small piece of filter paper in the corner of your eye to measure the amount of moisture in your eye over 5 minutes
- Corneal staining: Your doctor will place fluorescein dye (a usually harmless vegetable-based dye) on the surface of your eye, known as the cornea. The doctor will then look at your eye using a blue light. This checks the surface of your eye for any areas of damaged tissue or irritation.
Treatment for Sjögren’s syndrome depends on the severity of the condition and your individual needs. Your doctor will help you determine the best treatment for your needs. Some treatment may include:6
- Drinking more water during the day
- Using eye drops
- Prescription drugs to help with inflammation or irritation