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"Is it Sjogren's or Something Else?"

Updated: Dec 20, 2020

Dry eye can be a symptom of systemic conditions. Here are some tips for making a differential diagnosis.

Dry eye disease (DED) invokes an image of red, burning, irritated eyes that become noticeable in individuals who actively use digital devices, live in low humidity environments, or take antihistamines for allergies. These scenarios, in addition to advanced age, may increase one’s risk of developing DED, a condition in which triggers can be exacerbated by external factors. This condition is referred to as non-Sjögren DED. Its effects can be mitigated through the use of lubricants, antiinflammatory medications, and the avoidance of causative agents.

DED can also occur when an individual’s own body attacks its moisture-producing glands. In this case, although the symptoms are similar, the cause is internal and is recognized as the autoimmune condition known as Sjögren syndrome (SS). This systemic inflammatory disease primarily affects the lacrimal and salivary glands and may exist as a primary disorder. There are also secondary forms of SS, associated with other autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, or systemic sclerosis.1 Therefore, it is important to differentiate non-SS from SS DED in order to assist in the diagnosis of these seemingly similar syndromes (Table).

Seema Nanda, OD CEO and Director, Nanda Dry Eye & Vision Institute, Houston, Texas Adjunct Clinical Professor, University of Houston College of Optometry, Houston Instagram @nandatorynews

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