Dry eye in patients with Sjogren's Disease

Abstract

Purpose : Sjogren’s Disease is an autoimmune disorder which affects the salivary and lacrimal glands, leading to symptoms of severe dry mouth and dry eyes. The purpose of this study was to determine the symptoms, treatments, concurrent diagnoses, and ocular management of dry eye reported by patients diagnosed with Sjogren’s Disease.

Methods : A REDCap survey was distributed via websites of foundations dedicated to diseases which can affect the tear film and social media forums for patients with any form of dry eye disease. Participants completed the Ocular Surface Disease Index (OSDI) and responded to questions regarding their diagnosis, symptoms and management of their conditions.

Results : Five male and 233 female individuals with Sjogren’s disease responded to the survey. Mean(±SD, range) age was 57.4(12.0, 20-89) years. Over 75% of participants had symptoms of blurred vision, ocular burning, sandy/gritty/foreign body sensation, eye fatigue, and light sensitivity. The mean (±SD, range) OSDI score was 53.0 (20.9, 6-100), indicative of severe dry eye disease. Treatment with contact lenses was reported by 38 participants (16%), with soft lenses used by 19 participants and specialty lenses used by 19 patients. Other treatments included artificial tears (86%), warm compresses (52.9%), prescription eye drops (42.6%), lubricant ointment (33.1%), punctal plugs/cautery (31.8%), lid scrubs (28.9%) and oral medication (20.2%). Seventy-one percent reported difficulty locating eye care providers with expertise in dry eye disease; 31% did not believe that their eye care provider keeps them up to date on the most recent advances in dry eye treatment and management. Participants reported a mean(±SD, range) of 2.6(2.7, 0-20) visits with an eye care provider annually. When questioned as to their primary source of dry eye information, participants reported their eye care provider (44%), internet searches (26%) and online support groups/Facebook (24%). Participants reported concurrent diagnoses of rheumatoid arthritis (16.1%), allergies (38.8%), thyroid disease (33.9%), headaches/migraines (26.4%) and hypertension (26.4%).

Conclusions : Patients with Sjogren’s disease experience severe dry eye, and many have additional systemic diseases that can also negatively affect the tear film. A majority of patients surveyed reported difficulties finding a dry eye specialist. A multidisciplinary team of specialists, including eye care specialists, is often needed to manage these patients.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.