Dry Eye Disease In Sjogren’s: Treatment Options
If you’ve been diagnosed with Sjögren’s disease, you are likely familiar with one of its most persistent and frustrating symptoms: dry eyes.
As a Sjogren's patient and dry eye sufferer myself, I want to help you better understand the wide range of treatment options available to help manage symptoms and protect long-term eye health.
It is worth noting that dry eye disease in Sjögren’s is complex and often requires a layered, individualized treatment approach. So while all these treatment options are available to you, you might not require all of them in order to manage the disease. Understanding the mechanisms leading to dry eyes, and through proper testing, you can then target the dryness with the modalities listed below.
Understanding Sjogren's Disease
Sjögren’s disease is a chronic, systemic (whole body) autoimmune disease in which the immune system mistakenly attacks the body’s own healthy tissues. One of its primary targets is the exocrine (moisture‑producing) glands, leading to reduced secretion throughout the body.
These glands are responsible for producing moisture in areas such as:
The eyes (tears)
The mouth (saliva)
The nasal passages
The vaginal tissues
Sweat glands
Portions of the digestive system, including the stomach and pancreas
When the lacrimal (tear producing) glands are affected, tear production is significantly reduced, resulting in aqueous deficient dry eye. Over time, chronic inflammation can also disrupt the oil producing meibomian glands and damage the mucous producing goblet cells, further destabilizing the tear film and worsening symptoms.
If you would like to learn more about the composition of the tear film and how each layer can be negatively impacted or damaged in Sjogren's disease be sure to check out this blog post:
Treatment Options to Help Manage Dry Eyes in Sjogren's Disease
Managing Sjögren’s related dry eye often requires a combination of at home therapies, prescription treatments, in office procedures, and lifestyle adjustments. The options below are provided for educational purposes, and individual experiences may vary.
Eye Drops For Management Of Dry Eyes
Artificial tears are often the first line of treatment for dry eye disease. There are eye drops designed specifically for dry eye disease that may target lubrication, inflammation, or tear stability. This includes:
Preservative‑free eye drops which are strongly recommended, especially for frequent use, as preservatives can worsen inflammation and ocular surface damage over time.
Prescription eye drops which may be recommended in moderate to severe cases:
Restasis® and similar medications help reduce inflammation and increase natural tear production over time.
Alrex® or other short term steroid drops may be used to control flare ups and significant inflammation under close medical supervision.
Eye Gels and Ointment For Management of Dry Eyes
Eye gels have a thicker, more viscous consistency than standard artificial tears, allowing them to remain on the ocular surface longer.
They are particularly beneficial for moderate to severe dry eye and for patients who do not find sufficient relief with drops alone.
Many individuals with Sjögren’s experience worsening dryness overnight. Applying an ointment gel before bedtime can provide prolonged lubrication and reduce morning discomfort.
Certain over‑the‑counter gels may also help soothe inflammation and symptoms associated with blepharitis.
Heat Masks For Meibomian Gland Dysfunction (MGD)
Meibomian gland dysfunction (MDG) is common in Sjögren’s disease patients and contributes to rapid tear evaporation.
Warm compresses (or heat masks) are a common, cost effective option to help soften thickened oils within the meibomian glands, allowing them to flow more freely.
Using a heat mask regularly at home can improve tear quality when combined with eye drops or gels.
Products such as the Bruder Eye Compression Mask offers a convenient and affordable option for consistent heat therapy.
You can read a more in-depth understanding of Meibomian Gland Dysfunction (MGD) in this blog post: Blepharitis and Sjogren's Disease: What You Need to Know
Diet and Supplements For Dry Eye Disease
Diet and supplements play a crucial role in managing dry eyes, and incorporating specific nutrients can contribute to overall eye health.
Omega-3 fatty acids, found in fatty fish (such as salmon, mackerel, and trout), flaxseed, chia seeds, and walnuts, have anti-inflammatory properties. They can help reduce inflammation in the eyes and improve the quality of the tear film.
Staying well-hydrated is essential for overall health and is particularly important for individuals with dry eyes.
Scleral Lenses In The Management Of Severe Dry Eyes
For patients with moderate to severe Sjögren’s related dry eye, scleral lenses can be life‑changing.
These oversized, rigid contact lenses vault over the cornea and trap a reservoir of fluid against the eye’s surface.
This constant hydration protects the cornea, reduces pain, and often significantly improves visual clarity.
Scleral lenses are custom fit and require specialized care, but many patients report dramatic improvements in comfort and quality of life.
Here is an article written about a dry eye sufferer and how scleral lenses have helped to improve her quality of life.
Punctal Plugs To Help Manage Dry Eyes
Punctal plugs (also called lacrimal or tear duct plugs) are small, biocompatible devices placed into the tear drainage openings of the eyelids.
The plugs work by partially or completely blocking tear drainage, which then helps to retain natural tears on the eye’s surface for a longer period.
This increased tear retention can significantly reduce dryness and irritation, particularly in aqueous deficient dry eye.
Plugs may be temporary or long‑term, depending on patient needs and response.
Blephex for Blepharitis, Eyelid Inflammation and Infection
Blephex is an in-office treatment targeting blepharitis. Blepharitis is inflammation of the eye lids which can aggravate and contribute to dry eye disease and infection of the eye lids and lashes.
In this treatment the doctor uses a device to scrub bacterial debris off the surface of the eye lid (which is the leading cause of blepharitis).
Treatment has been reported to be well tolerated and only takes a couple minutes.
LipiFlow Dry Eye Treatment
Lipiflow® is a dry eye treatment where your eye doctor uses a device to remove gland blockages and restore meibomian gland function.
This ensures a targeted and effective treatment for meibomian gland dysfunction while prioritizing patient comfort and eye safety throughout the process.
iLux Treating Meibomian Gland Dysfunction
The iLux® device uses an LED light to gently raise the eyelid temperature and melt the substances blocking the meibomian glands.
The eye doctor will then apply compression to squeeze the melted substances from the lids, restoring the body’s natural oil production for naturally lubricated eyes.
Intense Pulsed Light (IPL) Therapy
Intense Pulsed Light (IPL) Therapy is another similar procedure that warms up the meibomian glands, often combined with digital gland expression and prescription medications for enhanced results.
IPL therapy usually consists of several treatments performed at 4-6 week intervals, followed by maintenance treatments as needed thereafter.
How to Choose the Right Dry Eye Treatment in Sjogren’s
Because Sjögren’s related dry eye disease is complex and often involves multiple tear film deficiencies, there is rarely a single “one-size-fits-all” solution. The most effective treatment plans are personalized to your needs, addressing both symptoms and the underlying causes of dryness.
When considering treatment options, the following factors are especially important:
Type of dry eye: Depending on which type of dry eye, aqueous-deficient dry eye, evaporative dry eye, or meibomian gland dysfunction different treatment options are available.
Severity of symptoms: Mild dryness may respond well to preservative free drops and lifestyle changes, while moderate to severe disease often requires prescription therapies or in-office procedures.
Presence of inflammation: Ongoing inflammation can worsen symptoms and damage the ocular surface, making anti-inflammatory treatments a key part of management.
Response to previous treatments: Dry eye management is often a process of trial and adjustment. What works at one stage of the disease may need to be modified over time.
Working closely with an optometrist or ophthalmologist who understands Sjögren’s disease is essential. Regular monitoring allows treatments to be adjusted as symptoms, gland function, and ocular surface health change.
If you are looking for brand specific product recommendations to help you manage your dry eyes due to Sjogren's disease, visit our product recommendations list here.
Comments