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Sjogren’s Syndrome: More Than Meets The “Eye”

Since Dr. Henrik Sjögren first identified and named the disease in 1933, it has been proven to affect virtually every racial and ethnic group. Awareness in regards to Sjogren’s syndrome is still lacking and increasing professional awareness is needed to help advance new diagnoses and treatment possibilities. 

Sjogren’s syndrome is a disorder of the immune system, which is most commonly recognized by two main symptoms, dry eyes and a dry mouth. With approximately four million Americans suffering from Sjogren’s, it is one of the more prevalent but lesser known autoimmune diseases. 

Primary Sjogren’s syndrome occurs in the absence of another underlying rheumatic or autoimmune disorder, whereas secondary Sjogren’s syndrome is associated with another underlying rheumatic disease, such as lupus, rheumatoid arthritis, or scleroderma. 

Since the symptoms of Sjogren’s syndrome can mimic other conditions and diseases, Sjogren’s can often be overlooked or misdiagnosed. On average, it takes a patient nearly three years to receive a diagnosis of Sjogren’s. Patients need to remember to be pro-active in talking with their doctors and dentists about their symptoms and potential therapies. 

In Sjogren’s syndrome, the mucous membranes and moisture- secreting glands in the eyes and mouth are usually affected first which results in decreased tear and saliva production. Other common symptoms of Sjogren’s syndrome are fatigue, and joint pain. However, this disease can also cause damage to organs such as the kidneys, gastrointestinal system, blood vessels, lungs, liver, pancreas, and the central nervous system. Unfortunately Sjogren’s patients also have a higher risk of developing lymphoma and should be screened for these issues on a regular basis. 

Sjogren’s is a systemic disease, affecting the entire body. Symptoms may remain steady, worsen, or, uncommonly, go into remission. While some people experience mild discomfort, others suffer debilitating symptoms that greatly impair their life. 

Although you can develop Sjogren’s syndrome at any age, most people are older than 40 at the time of diagnosis. The condition is much more common in women (9:1). Treatments focus on relieving symptoms and regulation of the immune system. Early diagnosis and proper treatment are important as they may prevent serious complications and greatly improve a patient’s quality of life. 

The dry eye disease (also know as Keratoconjunctivitis Sicca) found in Sjogren’s patients tends to be some of the most severe and tends to require a complex approach by the eye care provider. Thankfully we have had great advancements in regards to dry eye therapies in recent years including new pharmaceuticals such as Xiidra as well as new therapeutic devices such as TrueTear, scleral contact lenses, and LipiFlow that can help these patients better manage their disease and improve their ocular health, vision, and quality of life. 

The dry eye disease (also know as Keratoconjunctivitis Sicca) found in Sjogren’s patients tends to be more severe and requires a complex approach by the eye care provider. Thankfully we have had great advancements in regards to dry eye therapies in recent years, including new pharmaceuticals such as Xiidra (Lifitegrast) as well as new therapeutic devices and procedures such as the following: 

  • TrueTear is a new intranasal tear neuro-stimulation device used to increase tear production in patients with dry eye. 
  • Scleral Contact Lenses are therapeutic lenses that act as a synthetic environment for the ocular surface. 
  • LipiFlow is a new thermal pulse therapy to treat the congestion and obstruction commonly seen in the lids (Meibomian glands) of dry eye patients. 
  • Autologous Serum Eye Drops are essentially diluted blood serum that is thought to promote healing of the ocular surface by providing growth factors and nutrients to the ocular surface. 

Dry eye affects over 16 million people in the United States and this number is expected to double in the next decade with increased use of technology (such as mobile devices) and how we use our vision. Since early detection is the key, annual routine eye exams are highly recommended. This is the best avenue to take in order to preserve and maintain the best possible vision. 

About the author

Image of Jacob R. Lang, O.D., F.A.A.O.

Jacob R. Lang, O.D., F.A.A.O.

Dry Eye Disease, Comprehensive Optometry, Therapeutic Contact Lenses, Surgical Co-management,


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