What is Sjögren's Syndrome? Doctor Eye Health Explains
Sjogren’s syndrome is one of the most advanced conditions that can cause dry eye disease. This is an autoimmune condition that usually affects women between the ages of 40-50. However, men and younger women are not immune and can still be affected by this disease.
With autoimmune conditions, your body attacks itself. In the case of Sjogren’s, your body begins attacking your lacrimal gland, parotid gland, and can ultimately affect any mucus membrane in your body.
Symptoms of Sjögren's Syndrome
Because your lacrimal gland helps to lubricate the eyes, this condition can lead to severe dry eye disease due to aqueous deficiency. This simply means that your lacrimal gland becomes unable to produce the watery portion of your tear film, and your eyes produce less tears.
Many people will also notice a decrease in parotid gland secretion, and this gland is responsible for producing saliva. Very severe forms of dry mouth can result from Sjogren’s syndrome. The following symptoms are common with this condition:
Dry, irritated eyes
Red eyes and eyelids
Foreign body sensation of the eyes
Very dry mouth
Persistent dry cough
Increase in cavities and/or oral sores
Swelling, pain, and stiffness of joints
How is Sjögren's Syndrome Diagnosed?
If your dentist, eye doctor, or primary care doctor suspects this condition, they will order a blood test. Specific tests which should be ordered include an anti-SSA (anti-Ro), anti-SSB (anti-La), Rheumatoid Factor (RF), and Antinuclear Antibody Test (ANA). It should be noted that although these tests may come back positive, they often come back negative. However, if the symptoms are present, it’s worth it to push forward and obtain further testing.
Other tests which can be performed include a salivary gland scan and mucus membrane biopsy. With all of the above symptoms, your doctor may still make the diagnosis even though all testing states otherwise.
Natural Treatments for Sjögren's Syndrome
There is no cure for Sjogren’s syndrome and it can be associated with other diseases such as rheumatoid arthritis, lupus, and even a higher risk of non-Hodgkin's lymphoma. These patients, therefore, must be followed by a rheumatologist. Collaboration with a great dentist and optometrist or ophthalmologist is also strongly recommended.
That being said, there are natural ways you can begin to heal your eyes and ensure that the treatments your doctor recommends have the opportunity to work well. By taking care of your overall health and eyelid hygiene, you give yourself a better chance to heal.
Watch What You Eat
It's often recommended that those with Sjogren's syndrome follow an anti-inflammatory diet. This is because consuming foods such as alcohol, added sugar, processed goods, dairy, fried foods, and red meat can increase inflammation in the body. Instead, focus on plants. Fruits, vegetables, nuts, seeds, and other healthy fats are great ways to increase your body's ability to fight inflammation. For most people, we recommend starting small. Simply replace your breakfast with a green smoothie every single morning. if you'd like tips and recipes, find those here.
Hydrate Your Body
Dry mouth and dry eyes are the most common symptoms of Sjogren's syndrome. Do your eyes and mouth a favor and make sure you're drinking half your body weight in ounces of water per day. For a 150 pound person, that's about 75 ounces. Although this may seem daunting for those who are not used to drinking water, I can promise you that you'll begin to feel better as a whole. If you're concerned that this amount is too much for you, or you suffer from kidney disease or electrolyte imbalances, discuss your water intake with your primary care doctor.
Wash Your Face
For those who are able to wear eye makeup during the day, it is incredibly important to remove it completely at night. If you're allowing makeup to sit on your face and eyes all night, you're inviting bacteria to multiply and chemicals to invade your eyes. I recommend using an oil-based eye makeup remover followed by washing your face with a tea tree oil foam face wash or tea tree oil soap bar. Tea tree oil can be great for fighting demodex eyelash mites, bacteria, and inflammation, but if you find it too harsh you can simply use a natural, gentle cleanser with minimal ingredients.
Cleanse Your Eyelids
Arguably the most important step in this routine, cleansing your eyelids can make a huge difference in how you feel. We recommend cleansing your eyelids and eyelashes with a hypochlorous acid spray twice daily (once in the morning and once again at night). Hypochlorous acid is made naturally by the body to fight microorganisms, and it's a great complement to your body's healing capacity. Simply spray the solution onto your closed eyelids, rub it in with clean fingertips if you wish, and let it dry.
There is so much inflammation and dryness with Sjogrens that it can begin to cause damage to the surface of the eye, causing scarring and vision loss. Artificial tears are not enough for these patients, and the following treatments may provide further benefit to those with this condition.
Topical immunosuppressants can be very helpful in those with Sjogren’s syndrome. These medications help the lacrimal glands produce more tears, and this is the main deficiency in those suffering from this condition. The three medications available are dosed once in each eye twice per day.
By plugging the bottom (and and often the top) puncta of the eyelids, more of the tears you make are able to be kept on the eyes. If you’re hardly making any tears, each little bit can be important. This is why punctal plugs can be beneficial.
These are incredibly helpful for those with Sjogren’s who have ocular surface issues. These patients may have recurrent erosions, ulcers, or dry patches that can be treated well with these membranes. Membranes are usually placed on one eye at a time and last for about a week before they are removed.
In some Sjogren’s patients, long term topical steroids can be beneficial. Usually, topical steroids are not recommended long term due to an increased risk of intraocular pressure increase and cataracts. However, with proper monitoring by your eye doctor, topical steroids can provide a lot of relief for those struggling with so much inflammation.
Scleral Contact Lenses
Last on the list is scleral contact lenses. These large diameter, rigid contact lenses are beneficial because they completely vault over the cornea. When you insert the lenses, you first fill them with non preserved saline or non preserved artificial tears. This means that when you place the lens on your eye, you’re bathing your eyes in tears throughout the day.
As you can see, Sjogren’s syndrome can be a devastating condition with severe effects on the body. But with proper health care and follow-up, it is possible to live well and feel good.