Rheumatism: dry eyes with Sjögren’s syndrome

Rheumatism has different characteristic forms and manifests itself in different symptoms. Although rheumatism patients often suffer from dry eyes, the treatment of these is not usually the focus. Here, eye treatment should not be neglected, otherwise there can be lasting damage as a consequence. A special form of rheumatism is Sjögren’s syndrome, which mainly affects the functions of the mucous membranes and therefore the eyes.

Rheumatism can get into the eye

Over 100 diseases are grouped under the term “rheumatic diseases”. The best known is rheumatoid arthritis (chronic polyarthritis), in which the joints are chronically inflamed. The joints are destroyed more and more during the course of the disease. There is no cure, but the progression of the disease can be slowed down with a comprehensive therapy which includes medicines as well as occupational therapy and physiotherapy.

Most of the other diseases from the rheumatic disorders also affect the musculoskeletal system such as bones, muscles, tendons or ligaments. But other organs can also be affected by this chronic inflammatory disease, for example the lungs, heart, kidneys or eyes.

Sjögren’s syndrome is a rheumatic disease that affects the lacrimal and salivary glands as well as other glands of the mucous membranes. The main symptoms are dry eyes and a dry mouth. One talks of the primary form when Sjögren’s syndrome appears in isolation, without a connection to another disease being detected. The secondary form occurs in the course of an underlying rheumatic disease, for example rheumatoid arthritis.

How do the symptoms of rheumatism and Sjögren’s syndrome come about?

Many forms of rheumatic disease involve autoimmune reactions of the body, that is defensive reactions of the immune system against endogenous tissue. The causes of rheumatism have not yet been completely explained. Genetic predisposition and harmful environmental influences, above all smoking, appear to be possible triggers for rheumatism.

Sjögren’s syndrome is also an autoimmune disease. The immune system is also dysregulated in this case and among other things attacks the lacrimal and salivary glands. They become inflamed and their function is limited. As the disease progresses, the glands can ultimately be completely destroyed. How these autoimmune reactions come about is still unknown. Female sex hormones appear to have a role to play as a trigger, because women become ill significantly more frequently than men. Chronic virus infections are also under discussion as causes. The predisposition towards autoimmune diseases is hereditary.

How dry eyes from rheumatism or Sjögren’s syndrome manifest themselves

A feeling of having sand in your eye, constant burning and itching, a feeling of pressure and pain with every blink: the symptoms of dry eyes are unpleasant and impair vision. On the one hand, tear productsion can be impaired due to an autoimmune reaction so that there is insufficient lacrimal fluid available for lubricating the eye. On the other hand, the composition of the tear film can be disrupted and therefore break up the eye’s tear film.

Dry eyes can be the first symptom of a rheumatic disease. With Sjögren’s syndrome, the symptoms are at first only mildly noticeable. With time, the dryness in the mouth and the eyes becomes worse until finally tear productsion comes to a complete standstill. Artificial tears are required to lubricate the eyes. Other mucous membranes in the body can also dry out with Sjögren’s syndrome, for example the ones in the nose, the windpipe, the bronchial tubes or the genitals.

Diagnosis of Sjögren’s syndrome

Sjögren’s syndrome is not easy to identify because people afflicted usually go first to the specialist with their symptoms, for example with dry eyes to an eye doctor or with a dry mouth to the dentist. Furthermore, because the symptoms appear gradually, many patients have already got used to the dryness and do not describe the symptoms completely. Only when the connection between the symptoms is recognized can Sjögren’s syndrome be suspected as the cause. With the aid of tests on the dryness in the mouth and the eyes, it is possible to determine whether the symptoms are caused by such a disease. The suspicion of Sjögren’s syndrome can be confirmed with a blood test. With many people affected, but not all, the typical antibodies for the disease (SS-A and SS-B) are present in the blood.

Treatment of rheumatism-induced dry eyes

Rheumatism, including Sjögren’s syndrome, is still incurable. However, it is extremely important to treat the symptoms, above all the dry eyes. If the eye symptoms remain untreated, there is a risk of serious consequences: damage to the cornea, eye infections and eventual loss of sight are all possible.

The tear film can be maintained with lubricating eye drops, gels or ointments. HYLO® GEL eye drops contain a particular concentration of hyaluronan which makes the solution very viscous. This helps with severely dry eyes which have irritated cornea and conjunctiva.

In addition, the doctor can close the tear ducts with an operation so that the small amount of lacrimal fluid which is still produced does not drain away.

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