Dry Eyes and Sjogren’s Syndrome

Have you ever had those moments of self-awareness, like being aware that you’re breathing or that you’re blinking?

Allow us to introduce a new one to you: you are now aware that your eyes are wet.

Why are eyes wet?

The physical makeup of eyes may be kind of odd when you first think about them. Those little globes responsible for showing you the world around you are complex mechanisms — you have a lens system that receives and processes light, a muscle that dilates depending on how much light they take in, and they are full of fluid. Really, fluid is a good thing for your eyes. Not only does it keep a consistent pressure in your eye, critical for sight, but they also ensure that you are comfortable.

On the outside of your eyes, fluid and tears play an important role. They provide oxygen to the eye, protect your eyes from irritants, prevent infection, heal damage to the surface of the eye, and create a smooth surface for your eyelids to move on (you are now suddenly aware of blinking). On top of all this, tears keep your eyes moist. Your eyes, like your tongue, are covered in living cells. These cells are constantly growing or being replaced, and keeping wet keeps them going. In a dry environment, these cells wither up and die, which can be irritating and can sometimes lead to infection.

What is dry eye?

It’s kind of obvious. If your eyes aren’t wet, they’re dry. When cells in your eye are dry, you may experience an uncomfortable itchiness, burning sensation, or even redness. This happens when you can’t produce enough tears to cover the surface of the eye — also known as the tear film.

While it’s not uncommon to have episodes of dry eyes, it’s usually easily resolved by blinking to produce tears or sometimes with the assistance of eyedrops. However, there are conditions that make dry eye a chronic disorder, such as Sjogren’s Syndrome.

History of Sjogren’s Syndrome

Though cases were seen and recognized as some kind of disease as early as the late 1800s, Sjogren’s Syndrome became recognized (and named) by Dr. Henrik Sjogren in 1933. He found patients that all had low secretions from lacrimal and salivary glands. He even came up with a term just for dry eyes: keratoconjunctivitis sicca (try saying that five times fast!).

Okay, so what is it exactly?

Sjogren’s is one of several different auto-immune disorders. At the core, auto-immune disorders are system wide diseases where your immune system gets confused, attacking healthy parts of your body instead of infections. With Sjogren’s, our immune system attacks a series of glands throughout our bodies that can lead to chronic fatigue, dry mouth, and you guess it — chronic dry eye.

Out of all the known auto-immune disorders, Sjogren’s is actually one of the more common! It affects 200,000 people every year within the US. Eye-related symptoms of Sjogren’s Syndrome include having dry or itchy eyes, blurry vision, sensitivity to light, and blepharitis (an inflammation that can occur in the eyelid).

How is it diagnosed?

With any auto-immune disorder, Sjogren’s can never truly be cured. However, it can be treated and maintained. It all starts with a proper diagnosis.

Among 239,999 other ocular diseases, Sjogren’s is something we look for during you annual comprehensive eye exam. One way we do so is with a Shirmer’s test — that’s when we hold a strip of paper under your eye and measure the amount of tears that flow over a period of time.

We also sometimes examine the tiny, oil-producing glands in your eyelids. This oil is what helps keep your eyes wet and your tears… well, tear-y. So if we find these glands are swollen or blocked, it can be an indicator that you have Sjogren’s.

Of course, it can also be found and diagnosed through blood lab tests and by measuring the amount of saliva in your mouth – another area Sjogren’s Syndrome often manifests.

What can be done about it?

It’s very important to stay on top of Sjogren’s Syndrome. If left untreated, it can cause chronic irritation and discomfort or can even lead to infection and scarring.

For eyes, we may prescribe lubricating eye drops that keep your tears from drying out too quickly, leaving your eye more moist for a longer time than they usually would.

For Sjogren’s as a whole, it can be treated in a number of different ways. There are other, non-optometry-related drugs that can be prescribed to treat symptoms, for example.

There are also things you can do at home to help keep your eyes moist, even if you don’t have Sjogren’s. Drink plenty of water, use a humidifier if you live in a dry climate (which, let’s face it Nevada, if you don’t have a humidifier at this point, then how do you even survive the summer), and use eye drops if your eyes get dry.

And of course: tell us if your eyes are bothering you. Even if it doesn’t seem like a big deal, let us be the judge!

Header image from: Osmosis: Sjogren syndrome.