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Treatment of moderate to severe dry eye in Sjögren's syndrome

Alan N Baer, MD, FACP
Esen K Akpek, MD
Section Editor
Robert Fox, MD, PhD
Deputy Editor
Paul L Romain, MD


Sjögren's syndrome (SS) is a chronic multisystem inflammatory disorder characterized by diminished lacrimal and salivary gland secretions. This results in the "sicca complex," a combination of dry eye (xerophthalmia) and dry mouth (xerostomia). A variety of other disease manifestations may also be present, including ocular or systemic extraglandular features.

The term "keratoconjunctivitis sicca" was coined by Henrik Sjögren in 1933 to describe the ocular surface disease resulting from severe aqueous tear deficiency in a series of 19 patients [1]. This term has been largely supplanted in the medical literature by "dry eye."

SS occurs in a primary form not associated with other diseases and in a secondary form associated with other autoimmune rheumatic conditions, including rheumatoid arthritis and systemic lupus erythematosus.

The treatment of moderate to severe dry eye in patients with SS will be reviewed here. General principles of therapy, initial treatment, and the approach to mild dry eye in patients with SS are discussed separately, as are other issues in SS including the clinical manifestations and diagnosis of SS, the treatment of dry mouth and other non-ocular sicca symptoms in patients with SS, and the treatment of extraglandular manifestations of SS. (See "Treatment of dry eye in Sjögren's syndrome: General principles and initial therapy" and "Clinical manifestations of Sjögren's syndrome: Exocrine gland disease" and "Clinical manifestations of Sjögren's syndrome: Extraglandular disease" and "Diagnosis and classification of Sjögren's syndrome" and "Treatment of dry mouth and other non-ocular sicca symptoms in Sjögren's syndrome" and "Overview of the management and prognosis of Sjögren's syndrome".)

Dry eye unrelated to SS and an overview of dry eye, including the clinical manifestations, diagnosis, and management of dry eye unrelated to SS, are also presented separately. (See "Dry eyes" and "Diagnosis and classification of Sjögren's syndrome", section on 'Dry eye and mouth in older adults' and "Diagnosis and classification of Sjögren's syndrome".)

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Literature review current through: Nov 2017. | This topic last updated: Dec 07, 2017.
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