The ocular manifestations of Sjögren’s syndrome, especially dry eye, are considerable and more impactful than its other key symptoms, according to a recent study. Based on a survey that included a large group of patients with the condition, the researchers also report that dry eye not only worsens visual function and impacts the quality of life in Sjögren’s patients, but it can also cause significant emotional and financial burdens.

The survey included the responses of 2,961 adults who were approximately 65 years old; the majority were women (96%) and Caucasian (94%). More than half (53%) experienced severe dry eye (defined as having symptoms daily or almost daily, causing a major impact on their life) compared with symptoms of dry mouth (48%) and fatigue (45%). Almost all patients (97%) had used over-the-counter remedies of some kind.

Compared with non–dry eye patients, those who experienced significant dry eye were nearly four times more likely to say that living with Sjögren’s made every day a challenge and were more than twice as likely to experience a significant emotional burden. Adjusted odds ratios for the impact of dry eye were generally lower than those for fatigue, but similar to dry mouth and considerably higher than the use of systemic treatments for serious manifestations of the disease and the diagnosis of lymphoma.

Patients with more chronic disease and older age were more likely to experience severe dry eye, suggesting the complication might worsen with time, the study noted. Women, unemployed patients and those with corneal scarring were significantly more likely to experience severe dry eye. Photosensitivity was also a common ocular symptom in the study, with almost 50% of patients experiencing significant photosensitivity and almost 25% reporting severe photosensitivity.

“Ocular symptoms and signs should be included as an integral component of any tool designed to evaluate Sjögren’s,” the researchers wrote in their paper. “New therapies that specifically target Sjögren’s-related dry eye are needed to alleviate this burden and improve patient quality of life.”

Saldanha IJ, Vunya VY, McCoy SS. Ocular manifestations and burden related to Sjögren’s Syndrome: Results of a patient survey. American Journal of Ophthalmology. June 20, 2020. [Epub ahead of print].