Re: Dry Eyes/Sjogrens??

Posted By Sally on August 08, 1999 at 14:27:55
Dear Henry Ford Eye Doctor.
For 5 years I have been going from various doctors  with weird things.  Then the symptoms  would remiss and come calling again.
I live in a city of 7 million people so we do have an abundance of physicians.  
Perhaps I am self diagnosing myself as after 5 years, I have had to do my own research. I come up with Sjogrens.
Two weeks ago, I asked my Gyn doc to do an SSA-SSB, ANA and a Sed Rate.  All came back negative.  In Novemebr, I saw a parotid gland Specialist for swelling which gets bigger at times and then dies down to only a lil swelling.  The left side of my throat at times will not work to swallow.  My teeth at the gumlines are getting lil cavities for the past 2 years.  I brush and floss religioulsy.  Now, my eyes are so dry I can barely close them and there are sharp quick like pains in them.  There is also decrease in vision.   I had Angina like symptoms also for over a year. The list goes on.  
Friday, I saw an MD eye doc who examined my eyes.  (Had another MD eye doctor all these years but he had no answers) The corneas were damaged. He said this has been longstanding and asked if I had an ANA/SED and an SSA-SSB test done.  I told him Yes! and all negative...plus a negative glucose. He did a Shirmer's test.  Came back pretty bad after 5 minutes.  He did a Rose Bengel Test also.
He placed a silicone permanent plug in the left eye only(bottom)  to see how it would do.  In two weeks I go back and see him and hopefully I will get the right one done.  I am also using a humidifier like he suggested.  
Questions:  Can someone still have Sjogrens just of the eyes and mouth and not have it all over the body?  Is the SSA-SSB a good diagnostic test for Sjogrens. (mine was normal)   Also, when can a person see/know  results of this silicone permanent plug if it is going to help or not.  Are there other conditions that can cause dry eyes where the Shirmer's test is positive/very low in tears.  (2-4)
Thank You for helping.
Sally  

[HFHS MD JL]

Posted By HFHS MD-JL on August 09, 1999 at 09:05:05
Yes there is both an isolated and systemic form of Sjogren's.  The systemic form is more likely to be assoc with rheumatoid arthritis.  The blood test that you performed was the most specific test for this.  You can also have the salavary glands in your lip biopsied to try to make the diagnosis.  If you are also having parotid swelling you could also consider the diagnosis of sarcoidosis which is also an inflammatory condition that affects the tear and parotid glands.  You can discuss this with your physician.  
In two weeks you should notice some benefit from the plug, and if you do, I would have the other lower tear duct plugged.
This information was provided for educational purposes only.
HFHS MD-JL

[John__0__0]

Posted By John on August 09, 1999 at 18:41:31
This may sound like a dumb question, but are you also using artificial tears ? (Preferably non-preserved ones). Your corneas would have been damaged because they dried out due to the lack of tears. This can also cause some visual disturbance.











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