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How Sjogren's Disease Contributes to Chronic Dry Eye Disease and Meibomian Gland Dysfunction


Sjogren's Disease is a chronic autoimmune disease in the rheumatic disease family
How Sjogren's Syndrome Contributes to Chronic Dry Eye Disease and Meibomian Gland Dysfunction

What is Sjogren's Disease?

Sjogren's Disease, also known as Sjogren Syndrome, is a chronic autoimmune disorder that affects approximately 0.5-1% of the population.


The disease primarily affects the exocrine glands, which are responsible for producing saliva, tears, and other bodily fluids.


As a result, individuals with Sjogren's Disease often suffer from dry eyes, dry mouth, and other symptoms.


Does Sjogren's Cause Chronic Dry Eyes?

One of the most common manifestations of Sjogren's Disease is dry eye disease (DED), which is characterized by a lack of tear production and/or poor quality of tears.


Tears are essential for maintaining the health of the ocular surface, providing lubrication, nourishment, and protection against infections.


Tears are composed of three main components:

  • water,

  • lipids (oils),

  • and mucins (glycoproteins).

What is the lacrimal and meibomian glands?

The lacrimal gland, located above the eye, produces the aqueous component of tears, which makes up the majority of the tear volume.


The meibomian glands, located in the eyelids, produce the lipid component, which is essential for preventing evaporation of the tears. The mucin component is produced by the goblet cells located on the conjunctiva, the clear membrane that covers the white part of the eye.


How does Sjogren's impact the lacrimal and meibomian glands?

In Sjogren's Disease, the immune system attacks the exocrine glands, leading to reduced tear production and poor quality of tears.


Meibomian gland dysfunction (MGD) is also common in individuals with Sjogren's Disease, as the disease can cause inflammation and damage to the meibomian glands, leading to poor quality of lipids and evaporation of tears.


The reduced quantity and quality of tears in Sjogren's Disease can lead to a range of symptoms, including eye irritation, redness, pain, and sensitivity to light.


Individuals with Sjogren's Disease are also at increased risk of developing corneal ulcers and other ocular surface diseases.


What treatment is available for Sjogren's patients?

Treatment for Sjogren's Disease-related dry eye disease often involves a combination of lubricating eye drops, anti-inflammatory medications, and other therapies aimed at improving tear production and quality.


Meibomian gland dysfunction can also be treated with warm compresses, eyelid massage, and other therapies aimed at improving the quality of lipids in tears.


Heather hosts several support groups and has a great online presence in the Sjogrens' Diseases space. You can connect with her directly on TikTok.


Heather has compiled a list of products that can help Sjogren's patients manage dry eyes in the Amazon Storefront here.


Conclusion

Sjogren's Disease is a chronic autoimmune disorder that can lead to dry eye disease and meibomian gland dysfunction.


Tear composition and quantity are essential for maintaining the health of the ocular surface, and reduced tear production and poor quality of tears can lead to a range of symptoms and complications.


Early diagnosis and management of Sjogren's Disease-related dry eye disease are essential for preventing long-term damage to the ocular surface.


References:

  • Sjogren's syndrome. American College of Rheumatology. Retrieved from https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Sjogrens-Syndrome

  • The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye Workshop. Ocul Surf. 2007 Apr;5(2):75-92.

  • Management and therapy of dry eye disease: report of the Management and Therapy Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf. 2007 Apr;5(2):163-78.

  • Sullivan DA, Rocha EM, Aragona P, Clayton JA, Ding J, Golebiowski B, Hampel U, McDermott AM, Schaumberg DA, Srinivasan S, Versura P, Willcox MDP. TFOS DEWS II Sex, Gender, and Hormones

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