Sjogren’s (SHOW-grins) syndrome is one of the most prevalent but lesser-known of the autoimmune diseases. Sjogren’s affects about 0.5% of the population, about half as many as those who have rheumatoid arthritis. Rheumatoid arthritis affects about 1% of the population.
Sjogren’s syndrome usually first affects the mucous membranes and the moisture-secreting glands of the eyes and mouth. This causes decreased tears (dry eyes) and saliva (dry mouth). This autoimmune syndrome can develop at any age but is most common in those older than 40 and is more common in women. There is no cure for Sjogren’s syndrome, so treatment focuses on relieving symptoms.
Symptoms of Sjogren’s syndrome
The two main symptoms are dry eyes and dry mouth caused by the immune system mistakenly attacking the body’s own cells and tissues. The cause for this autoimmune disorder is still unknown, but a theory is that a triggering mechanism causes the immune system to malfunction and that triggering mechanism can be an infection with a virus or a bacteria.
Your eye doctor may be able to detect and diagnose Sjogren’s syndrome from your dry eye symptoms as well as other diagnostic tests and a review of your symptoms.
If your diagnosis is Sjogren’s syndrome the treatment for your dry eye will be different from typical dry eye disease.
Sjogren’s Syndrome Treatments
Because Sjogren’s syndrome is an autoimmune disease, lubricating eye drops will only provide temporary relief but will not address the source of the problem. Your doctor may prescribe cyclosporine eye drops that suppress your immune response and decrease the swelling that Sjogren’s causes in your lacrimal glands so that your tear production is increased.
Cyclosporine eye drops come in single-use vials (small bottles to be used for one dose) and in a multi-dose bottle (a bottle that can be used more than once). If you are using the single-use vials, the liquid from a vial should be used immediately after opening for one or both eyes.
You may also be prescribed pilocarpine hydrochloride or cevimeline. Both of these drugs stimulate the lacrimal glands to produce more tears and they stimulate the salivary glands to create more saliva. Both medications are taken orally three times a day.
Another option to treat your dry eyes from Sjogren’s syndrome are punctal plugs. They are tiny plugs placed in the tear ducts to partially block the drainage of tears and increase lubrication in the eyes. Inserting the plugs is a painless procedure that takes only a few minutes and can be done in your ophthalmologist’s office.
Progression of Sjogren’s Syndrome
Sjogren’s syndrome first damages the glands that produce tears and saliva, but the condition can go on to damage other parts of your body such as your joints, kidneys, lungs, skin, liver, and nerves. If you think your dry eyes and dry mouth are caused by Sjogren’s schedule an eye exam so your doctor can examine your eyes and assess your medical history.
There is no single test that will confirm the diagnosis of Sjogren’s. Your doctor will have to conduct a series of tests and ask about your symptoms.
The tests include blood tests that can detect the presence of autoantibodies that are found in patients with several types of systemic autoimmune diseases. An eye test that measures tear production and examinations of the surface of the eyes for dry spots. Dental tests that measure salivary flow may also be used.