Sjögren’s syndrome is a condition that affects parts of the body that produce fluids, like tears and spit (saliva).
It’s a long-term condition that can affect your daily life, but treatments help relieve the symptoms.
Treatment for Sjogren’s Dry Eyes
TheraLife developed a formula (TheraLIfe Autoimmune) specifically for Sjogren’s Syndrome to address the underlying dry eyes, autoimmune flares, and joint pain.
TheraLife also developed a protocol to address other aspects of Sjogren’s dry eyes, such as MGD (meibomian Gland Dysfunction) and blepharitis (crusty eyes) simultaneously.
To learn more about how it works, click here
TheraLife Sjogren Customer Story
Sjogren’s Dry Eyes – Relief by TheraLife Autoimmune
I first found out that I had Sjogren’s severe dry eyes six (6) years ago. My eye doctor put me on Restasis for the first year plus systane drops. I used eye drops all day long with no relief. My eyes were getting worse throughout the six years, and I felt miserable at the end of each day. My eyes were so red and uncomfortable – I just wanted to pull my eyes out. I was not a happy person, very depressed, and had no social life; all I wanted to do was close my eyes. I would pray for a miracle every day. I went online and searched for alternative medicine. I can say my prayers have been answered. I have been on TheraLife Autoimmune for three (3) months, and I have my life back again. My family and co-workers also noticed the significant difference in my eyes; they are pleased. TheraLife Autoimmune is worth every penny. TheaLife is the best thing that ever happened to me, and it’s the answer to my prayers.
E A, Hollister, CA
What is Sjogren’s
Sjögren’s syndrome can exacerbate people’s dry eye signs and symptoms.
Sjogren’s syndrome is the second most common autoimmune rheumatic disease.
Statistically affecting between three and six-person per 100,000 Americans. The peak incidence is between the ages of 40 and 60, with a higher incidence in women than men (9 to 1)
Most challenging is that a dry eye diagnosis in patients with Sjogren’s Syndrome can precede systemic symptoms and complications by almost ten years.
Symptoms of Sjögren’s syndrome
The symptoms of Sjögren’s syndrome include:
- dry eyes
- a dry mouth
- dry skin
- vaginal dryness
- muscle or joint pain
- swelling between the jaw and ears (swollen salivary glands)
- rashes (especially after being in the sun)
Causes of Sjögren’s syndrome
Sjögren’s syndrome is caused by the immune system (the body’s defense against infection), damaging healthy parts of the body – this is known as an autoimmune condition.
The condition usually affects areas of the body that produce fluids, such as tears and saliva. But other parts of the body, such as nerves and joints, can also be affected.
It’s not clear why the immune system stops working correctly.
It may be linked to:
- genetics – some people may be born with genes that make them more likely to get an autoimmune condition
- hormones – the female hormone estrogen may play a part, as the situation is much more common in women than men
Primary Sjögren’s syndrome is where you do not have any other related conditions.
Things you can do if you have Sjögren’s syndrome
To help relieve the symptoms of Sjögren’s syndrome:
- avoid dry, smoky, or windy places
- avoid reading, watching TV, or looking at screens for a long time
- make sure you maintain good oral hygiene
- do not smoke or drink alcohol
- do not eat spicy food, drying foods like pasta that soaks up saliva
Sjogren’s Syndrome diagnosis can be difficult because of the associated symptoms and comorbidities. Experts have sought to create diagnostic guidelines for patient inclusion in clinical and research trials. The American-European Consensus Group (AECG) developed criteria in 2002 for use in clinical trials with the following parameters:
- subjective ocular and oral dryness,
- dry eye testing using Schirmer’s test,
- reduced salivary flow,
- positive salivary gland biopsy
- positive autoantibodies against SS-A and SS-B, with the last two as mandatory requirements.
- biomarker positivity (Ro or La) or positive rheumatoid factor (RF)
- antinuclear antigen (ANA) or labial salivary gland biopsy findings
- keratoconjunctivitis sicca- dry eyes.
Biopsy of the minor salivary glands remains the most specific test to diagnose Sjögren’s syndrome and is a necessary diagnostic component. Though invasive, a biopsy is specific for Sjogren’s Syndrome. Damage may have already occurred in the glandular systems. The salivary gland biopsy must be performed by a trained professional and reviewed by a pathologist. Salivary gland ultrasonography and acoustic radiation force impulse of the parotid and submandibular glands can help identify anatomical and functional damage in patients diagnosed with Sjogren’s Syndrome.
Dry eyes in Sjogren’s
Dry eyes disease is one of the hallmark signs of Sjogren’s Syndrome, which requires eye doctors to be an integral part of patient management. Since dry eye symptoms can happen before the systemic effects of Sjogren’s Syndrome, therefore diagnosing Dry eye disease can often be the first step in identifying Sjogren’s syndrome. Doctors should suspect Sjogren’s Syndrome when patients present with complicated dry eye, inflammation, and dry mouth. Lack of tears is commonly associated with Sjogren’s Syndrome because immune cells attack the lacrimal glands that produce tears.
In the clinical setting, doctors know dry eye can adversely affect patients’ quality of life. The Ocular Surface Disease Index (OSDI) correlates the symptoms of DED with its effect on visual function. It can be incorporated into clinical practice to successfully grade the degree of DED from normal, mild to moderate, and severe.
People with Sjogren’s often complain of burning, stinging, foreign body sensation, itching, pain, and blurred vision. Tear film irregularities show a decreased tear production. Thus, ocular dyes and tear secretion tests, such as Schirmer’s test, can help diagnose Dry eye disease. Fluorescein, rose Bengal, and lissamine green dyes can help evaluate the tear film and conjunctiva. With fluorescein dye, we look for tear film is assessed for dark spots, which indicate the tear break-up time (TBUT). Normal TBUT is greater than 10 seconds, and anything less than 10 seconds is indicative of Dry eye disease.
Schirmer’s test measures the total tear secretion rate. Schirmer’s test without topical anesthetic quantifies reflex tear secretion, while testing with topical anesthetic quantifies basal tears. People who test positive for Dry eye disease have <5mm to 7mm measurements for reflex tear secretion and <3mm for basal secretion.
The Sjö test is a biomarker specific for Sjogren’s syndrome. The traditional Sjogren’s biomarkers are anti-SS-A/R0, anti-SS-B/La, ANA, and RF. New biomarkers are salivary gland protein-1, parotid secretory protein, and carbonic anhydrase VI. The addition of the new biomarkers allows for better sensitivity and specificity because of their possible early detection of Sjogren’s. Case reports show people who had an early diagnosis of SS tested positive for the new biomarkers after they had already tested negative for the traditional biomarkers. If results return positive for Sjogren’s, people are referred to a rheumatologist for further management and testing.
Tradfitional Treatments for Sjögren’s syndrome
There’s currently no cure for Sjögren’s syndrome, but there are several treatments that can help, such as:
- eye drops that keep your eyes wet (artificial tears)
- sprays, lozenges (medicated sweets), and gels that keep your mouth moist (saliva substitutes)
- medicine that helps your body produce more tears and saliva- hydroquinone.
With no cure for Sjogren’s, the therapeutic goals are to eliminate the hallmark complaints of dry eye and dry mouth. Simple changes, such as modifying the environment (e.g., reducing time spent in dry or windy environments), can relieve mild dry eyes. Other methods include eyelid hygiene and following a diet high in omega-3 fatty acids.
Artificial tears are used as the first line of dry eye therapy. The ingredients in artificial tears, mainly a polymeric base or a viscosity agent, are designed to increase the amount of time the tears are on the ocular surface, increasing the tear meniscus. Different classes of artificial tears have different formulations, and some may work better than others. For example, some contain potassium and bicarbonate ions. In contrast, others are designed to configure the lipid portion of the tear film. Watch out for specific ingredients of preservatives that can be toxic and make dry eye worse in eye drops. Gel tears and ophthalmic ointments are thicker and last longer on the ocular surface but can cause temporary blurred vision. Ointments are best reserved for nighttime use and can help to relieve dry eye symptoms during sleep.
Living with Sjögren’s syndrome
Sjögren’s syndrome is a long-term condition that does not usually get better on its own, but symptoms can be treated.
It may just be a bit of a nuisance for some people, while for others, it can have a significant impact on their daily life.
Some people may develop complications of Sjögren’s syndrome, such as problems with their vision or lungs.
There’s also a slightly increased risk of a type of cancer called non-Hodgkin lymphoma.
Treating and managing people with Sjogren’s include lifestyle changes and artificial tears initially. Each person will respond differently to a treatment. Therapy must be modified as signs or symptoms change, but relieving subjective and objective complaints will remain imperative to improving quality of life.