Sjogren’s syndrome means more than just dry eyes

Dear Doctor K: I have Sjogren’s syndrome. People tend to dismiss it as a problem with dry eyes, but it’s so much more than that. Can you please describe this condition for your readers?

Answer: Sjogren’s (pronounced “show grins”) syndrome is a lifelong condition. It does tend to be best known for causing dry eyes, but it can cause other problems as well. For example, Sjogren’s syndrome can produce dry mouth and affect any of the body’s glands, including those that secrete sweat, saliva and oil. About half of people with Sjogren’s syndrome also have another connective-tissue disease such as rheumatoid arthritis or lupus.

Named after Swedish eye doctor Dr. Henrik Sjogren, this syndrome affects people of all ages and races. However, 90 percent of all cases involve women, most commonly between the ages of 45 and 55.

Sjogren’s syndrome is an autoimmune disorder. That means the body’s immune system mistakenly attacks the body’s own cells and organs. The immune system exists to attack foreign microbes (like bacteria or viruses) or substances that invade our body. In autoimmune diseases, however, the immune system seems to think the body’s cells and organs are foreign invaders that need to be eradicated.

In Sjogren’s syndrome, the immune system attacks the organs that normally produce lubricating fluid. These include the salivary glands in the mouth and the lacrimal glands in the eye. This eventually causes a marked reduction in tear and saliva production, leading to the characteristic dryness of the eyes and mouth.

Dry mouth and dry eyes may not sound all that bad to someone who has never experienced them. But consider the many consequences these conditions can bring about. Dry mouth can cause tooth decay, periodontal disease, salivary gland stones or infection, oral fungal infections and mouth sores. Difficulty swallowing and eating can lead to weight loss and malnutrition.

Dry eyes can produce blurred vision and the feeling that there is sand in the eye. Insufficient lubrication of the eyes can also lead to bacterial infection of the conjunctiva (the thin membrane that covers the inner surface of the eyelid and the white part of the eyeball), damage to the cornea and even vision loss.

Besides causing potentially serious problems of the eyes and mouth, Sjogren’s syndrome can impact other parts of the body. Fortunately, this is uncommon. Outside of the eyes and mouth, Sjogren’s syndrome is most likely to affect the lymph glands, which can swell and become quite large. Indeed, people with this syndrome also have a higher risk of developing cancer, particularly lymphoma (cancer of the lymph glands).

Sjogren’s syndrome also can affect the skin, muscles, joints and vagina, making them stiff, sore and dry. Worse, it can damage organs that are essential for life: the lungs, pancreas, kidneys, skin and brain.

So I agree with you: While it often is a mildly irritating condition, it can be quite severe. Fortunately, proper treatment can help to relieve symptoms. Artificial tears keep the eyes moist. Various treatments that quiet the immune system’s attack on the glands that make tears also can be very effective.