What Ophthalmologists Should Know About Sjögren’s Syndrome

Abstract

About one-quarter of patients with dry-eye syndrome (DES) have an underlying rheumatic condition, most commonly Sjogren’s syndrome (SS). SS is a common, frequently underdiagnosed cause of dry eye with multisystemic involvement. The immunological background of SS involves activation of both innate and acquired immune systems. According to the 2002 American and European classification systems, presence of any four of the six criteria (i.e. symptoms of dry eye, symptoms of dry mouth, ocular signs of dry eye, objective salivary gland involvement, typical histopathology findings in minor salivary gland biopsy specimens and presence of serum autoantibodies) as long as either the biopsy or serology is positive or presence of any three of the four objective criteria is considered diagnostic of SS. The main goal of treatment of ocular involvement is the alleviation of dry-eye symptoms with replacement therapy, stimulation of tear secretion and supportive surgical procedures to conserve tears. Preservative-free tear substitutes, topical steroids, cyclosporine A, autologous serum eye-drops and punctal plugs are commonly used for this purpose.