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Ocular staining worse in dry eye patients with Sjögren’s syndrome
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CHICAGO – Patients with Sjögren’s syndrome were found to have significantly worse ocular surface and Delphi global staining scores than patients with aqueous deficient dry eye, according to a study presented at the American Academy of Optometry meeting.
Barbara Caffery, OD, PhD, FAAO, and colleagues reviewed charts of 123 patients with Sjögren’s syndrome from six optometric offices and 86 patients without Sjögren’s but with aqueous deficient dry eye (ADDE) who were screened in a Sjögren’s clinic, according to the study abstract.
Researchers considered symptoms; corneal staining with fluorescein, lissamine green or rose bengal; and tear break-up time. They determined which was the worse eye based on staining.
They reported that patients with Sjögren’s syndrome had significantly greater worse eye corneal and conjunctival staining; however, symptoms were no different in the two groups. Based on the Delphi global severity score, 43% of those with Sjögren’s syndrome and 17.4% of those with ADDE had grade 4 severity.
Researchers concluded in study that grading these variables can help clinicians differentiate between the two different types of dry eye.
“Any patient with dry eye symptoms and any with a rheumatic autoimmune disease that is already diagnosed should be stained,” Caffery told Primary Care Optometry News in an interview. “Also, any female patient with a dry mouth and unusual fatigue should be stained.”
If a patient is a Sjögren’s suspect, ask about dry mouth, fatigue and family history of rheumatic autoimmune diseases, Caffery said.
“If you still suspect Sjögren’s, then ask the family practitioner to do blood work for anti-Ro and anti-La and ANA,” she said. “If you are still questioning, send the patient to a rheumatologist for analysis and a lip biopsy.” – by Nancy Hemphill, ELS, FAAO
Reference:
Caffery B, et al. Comparison of the severity of dry eye in Sjögren’s syndrome versus aqueous-deficient dry eye. Presented at: American Academy of Optometry; Chicago; Oct. 10-14, 2017.
Disclosure: Caffery reported no relevant financial disclosures.