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Eye Care Archive (Expert Forum)
Dry Eye or Sjogren's or something else?
Our Ask A Doctor Ophthalmology Forum is where you can post your question and receive a personal answer from physicians affiliated with the American Academy of Ophthalmology.
Dry Eye or Sjogren's or something else?
by Juliet1971, Jun 05, 2006 12:00AM
I'm a 35 yo female with a history of very mild colitis. Two weeks ago, I caught a virus from my son that gave me a rash on my neck and face. My PCP said it was related to the virus, no big deal (I expressed my concern about immume problems...I'm paranoid!). The next day, I had eye appt to get a new script and evaluate floaters. The doc said floaters were normal, but that my eyes were a bit dry and recommended using Thera-Tears gel at night. Over the next three days, my eyes felt more dry. I flew across the country on the third day and was in a LOT of discomfort. The next day, my inner lids were very red and my eyes were getting red. I went to the ER and the doc said it looked like non-infectious conjunctivitis caused by dry eyes. He prescribed Voltaran to use for a few days to reduce inflammation and to be seen by an eye doc ASAP.
So, I see an eye doc a couple of days later (not my regular eye doc, since I'm on vacation). He does a thorough exam...tear production test (10 mm in both eyes, dry, but not super super dry), slit lamp with some kind of dye that was yellow-green, watched my tear film evaporate. He concluded that my lacrimal glands look OK but my meibomian (sp?) glands are not functioning well at all, so tears are evaporating too fast. He recommended using Thera-Tears vitamins for 2 mos and using Thera-tears drops constantly. He said that he really didn't see evidence of an autoimmune problem.
I am, obviously, still nervous. I had a negative ANA and sed rate 8 mos ago. Is mebomian gland disfunction commonly related to Sjogren's or is this just dry eye syndrome?
So, I see an eye doc a couple of days later (not my regular eye doc, since I'm on vacation). He does a thorough exam...tear production test (10 mm in both eyes, dry, but not super super dry), slit lamp with some kind of dye that was yellow-green, watched my tear film evaporate. He concluded that my lacrimal glands look OK but my meibomian (sp?) glands are not functioning well at all, so tears are evaporating too fast. He recommended using Thera-Tears vitamins for 2 mos and using Thera-tears drops constantly. He said that he really didn't see evidence of an autoimmune problem.
I am, obviously, still nervous. I had a negative ANA and sed rate 8 mos ago. Is mebomian gland disfunction commonly related to Sjogren's or is this just dry eye syndrome?
Doctor's Answer
by Forum-OD-MP, Jun 05, 2006 12:00AM
sjogrens causes autoimmune damage to the lacrimal gland, which would cause a severe decrease in your tear production test, which you do not have. sjogrens in a 35 year old would be really rare, plus you'd have a lot of other problems like severe dry mouth, etc, which you dont mention. so i'm going to say autoimmune disease is unlikely.
the single most common cause of dry eye in a non-contact lens wearer is gland disfunction. i would have suggested the exact same thing your last eye doc suggested...omega 3 oral supplement (thera tears nutrition gelcap pills) and artificial tears, and re-eval in 2-3 months.
the single most common cause of dry eye in a non-contact lens wearer is gland disfunction. i would have suggested the exact same thing your last eye doc suggested...omega 3 oral supplement (thera tears nutrition gelcap pills) and artificial tears, and re-eval in 2-3 months.
Thanks!
Nieka
N.
Now to get my anxiety about all of this under control...
Cheers!
N.
http://www.wiseorb.com/articles-review-478-T-DRY_EYES%3A_THE_PROBLEM_OF_THIS_TIME%2E.htm