Sjögren’s Syndrome: Understanding Symptoms And Alleviating Daily Discomfort
Prevention and Treatment Although you may view dry eyes as a minor nuisance, the more than 400,000 Canadians who suffer from Sjögren’s Syndrome might take exception to that perspective.
“Dry eyes in a milder form are simply irritating, but in a more severe form it can be quite painful,” says Dr. Paul Geneau, President of the Canadian Association of Optometrists. Sjögren’s can have a “very, very significant effect on somebody’s life,” leaving some patients unable to carry out activities such as driving. If left untreated, Sjögren’s Syndrome can damage the cornea, which, in extreme cases, can lead to blindness.
A little-known autoimmune disorder, Sjögren’s Syndrome primarily affects salivary and lacrimal (tear-secreting) glands. In addition to dry mouth, patients have “very, very dry and gravelly eyes,” according to Dr. Barbara Caffery, an optometrist who specializes in Sjögren’s. Sometimes this systemic disease, which mainly affects women, can accompany rheumatoid arthritis or lupus.
Different dry eye conditions
Sjögren’s Syndrome is the most common and most severe form of aqueous deficient dry eye disease (the tear-secreting glands do not produce enough of the watery layer of the tears). Another common dry eye condition is evaporative dry eye disease, which may result when glands in the eyelids are inflamed or plugged and cannot produce enough of protective oil in tears.
Moistening the eyes with artificial tears is a key treatment for all dry eye conditions. “They can make a huge difference in quality of life,” says Dr. Sheldon Herzig, Medical Director of the Herzig Eye Institute. He recommends non-preserved tear drops for Sjögren’s patients because of frequent use — “there are people that have to put them in every few minutes, every half hour.” In addition, Sjögren’s patients often have such sensitive eyes “you have to work through several drops to get to one that actually works,” says Dr. Caffery. Your eye doctor can discuss various options and recommend drops that may be right for you.
People with severely dry eyes may also need to use gel or ointment on their eyes. Gels are non-blurring and are appropriate for both daytime and night-time use for extended relief of symptoms, whereas ointments tend to blur so are usually reserved for night-time use. Some may elect to have a tiny silicone plug inserted into their tear ducts to prevent tears from draining away. Others use a prescription medication, which can help improve the tearing of the eye. Some Sjögren’s patients have such dry eyes they can’t keep them open unless they use moisture chambers, goggles that keep moisture on the eyes, says Dr. Geneau. Cleaning your eyelids daily with a gentle eyelid cleanser and using hot compresses to keep the lid glands open and functioning is also recommended.
A healthy lifestyle can benefit Sjögren’s patients, according to Dr. Caffery, who says that omega-3 fatty acids may help reduce inflammation and increase the functioning of the meibomian glands.
Adopt a healthy lifestyle
A healthy lifestyle can benefit Sjögren’s patients, according to Dr. Caffery, who says that omega-3 fatty acids may help reduce inflammation and increase the functioning of the meibomian glands. If you do not consume enough omega-3 in your diet, through sources such as salmon or other oily fish, ask your eye care professional which omega-3 supplement is right for you. Getting enough sleep, drinking lots of water, cutting back on dehydrating drinks like coffee and alcohol, and avoiding decongestants and antihistamines are also recommended.
Manage your environment
Environmental conditions such as low humidity can exacerbate dry eyes. “Humidifying home and work is the best thing you could do,” says Dr. Herzig. Because tear production diminishes when we sleep, a very dry bedroom can lead some patients to wake up with eyes so dry it’s like they are “glued shut.”
In addition, Sjögren’s patients need to be on guard when outdoors. “You cannot be out in the wind, you cannot be in a smoky environment or dusty environment because the eyes suffer too much,” says
As with most autoimmune diseases, there is no cure for Sjögren’s. “Many of these patients once we get them organized on their regime of care seem to go along quite well,” says Dr. Caffery. “If they can manage their symptoms, they can live a much better day.”