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(I-MED Pharma)
Sjögren’s syndrome is an autoimmune disease where the immune system attacks healthy tissues within the body, causing a wide variety of symptoms ranging from gland dysfunction to major organ dysfunction. As a result, the glands that produce fluids, such as tears, are affected. This leads to a poor production of tears causing chronic dry eye, where patients suffer a wide array of uncomfortable and painful ocular symptoms. A 2021 patient survey conducted by the Harris Poll on behalf of the Sjögren’s Foundation saw that 94% of people with Sjögren’s disease suffer from dry eye disease, with 75% of respondents stating that this symptom has a moderate or major impact on their life. [1]
What are the symptoms and warning signs of Sjögren’s syndrome?
Symptoms of Sjögren’s typically include extensive dryness (in the eyes and mouth), profound fatigue, chronic pain, major organ dysfunction in the kidneys, gastrointestinal systems, blood vessels, lungs, liver, pancreas, as well as the central nervous system, and patients have a higher chance of developing lymphoma. [2] Due to the wide scope of symptoms, this disease is often misdiagnosed or overlooked.
Early signs of Sjögren’s syndrome can include nerve inflammation and damage (numbness or weakness or burning/cold sensations especially in hands and feet), brain fog, trouble concentrating, enlarged glands, fatigue, dry and itchy skin, and a persistent cough. [3] While this disease can affect anyone of any gender or age, it is more prevalent in women over 40 years old, although a growing number of patients have been getting diagnosed under 18 years old. [4]
What are causes and long-term effects of Sjögren’s syndrome?
Sjögren’s syndrome is an autoimmune disorder, meaning the immune system mistakenly attacks healthy tissues within the body. [5] It is still unclear to researchers as to why the immune system begins behaving this way, however it is believed that genetics may play a role, as well as a predisposition to developing an autoimmune condition. [6] Hormones may also play a role, especially female hormones, since the condition is more prevalent in women. It’s also important to note that many people suffering from Sjögren’s syndrome have another autoimmune condition such as rheumatoid arthritis or lupus. [7]
Long term effects of Sjögren’s syndrome can be harmful if symptoms are not treated/managed accordingly. Ocular damage can be prevented by regularly consulting with a doctor, and by creating a treatment plan to help control inflammation and prevent further damage. Patients suffering from Sjögren’s syndrome also have a higher probability of developing cancer of the lymph nodes, which can be treated effectively if detected in the early stages. [8]
What is the relationship between Sjögren’s syndrome and dry eye disease?
Dry eye disease is a multifactorial disease that affects the ability of the eye to stay moisturized and lubricated, due to a problem in the production or quality of tears. When suffering from Sjögren’s syndrome, a patient’s white blood cells mistakenly invade tear producing glands, causing inflammation, and reducing secretion. [9] This leads to chronic dry eye, where patients can experience major negative impact on quality of life, from ocular discomfort to visual dysfunction. [10] Corneal scarring, ulceration, infection and even perforation can occur to the eyes in cases of severe dry eye. [11]
How can a Sjögren’s sufferer manage their dry eye symptoms?
It’s important for those suffering from Sjögren’s syndrome to take the appropriate measures to help manage their dry eye symptoms and help alleviate their discomfort. It is often recommended to take a multi-stepped approach to managing dry eye, as shown below.
I-MED Pharma’s line of I-DROP® artificial tears are preservative-free eye drops that contain a high-quality hyaluronic acid which leads to longer-lasting hydration and lubrication. I-DROP® products are non-blurring upon application, and do not cause any foreign body sensation. Due to the long-lasting hydrating properties, patients require less drops during the day versus other drops available in pharmacies. This is more cost-effective for the patient allowing for a lower therapy cost.
I-DROP® PUR provides relief for those suffering from mild to moderate dry eye and is recommended for contact lens wearers.
I-DROP® PUR GEL provides relief for those suffering from moderate to severe dry eye and is recommended for use with scleral lenses and in harsh weather conditions.
I-DROP® MGD provides relief for those suffering from severe to chronic dry eye and is recommended for those suffering from Meibomian Gland Dysfunction.
Therapeutic Mask
Eye care professionals often recommend moist heat therapy as a form of supplementary treatment for people suffering from dry eyes and other conditions of the eyelid. Hot compresses, such as the I-RELIEFTM therapeutic eye mask warms up the meibomian glands and allows the oils to liquify and secrete into the tears. Consistent use over time can help increase blood circulation, stimulate lipid oil production, and reduce tear evaporation, thereby improving overall ocular health.
Ocular Hygiene
Adding a daily hygiene regimen to an existing management plan using lubricating eye drops helps break the dry eye cycle, while enhancing the effectiveness of artificial tears such as I-DROP®, and aids in the restoration of corneal health. Used daily, I-LID ’N LASH® helps clean the eyelids and eyelashes by removing ocular debris and keeping the ocular region clean and healthy. The full I-LID ’N LASH® product line is safe and gentle, even on sensitive skin.
I-LID ’N LASH® is an effective water-based cleanser that is recommended for patients to use daily to remove ocular debris and reduce bacteria It is available in a jar of 60 pre-soaked wipes and a 50 mL pump.
I-LID ’N LASH® PLUS is an effective water-based cleanser that contains 5% tea tree oil and is recommended for patients requiring a deeper cleansing of the lids and lashes. It is available in a jar of 60 pre-soaked wipes.
I-LID ’N LASH® HOCL is a convenient ocular cleansing and hydrating spray formulated with .2% pure HOCl for lids and lashes. It is available in a 120 mL bottle. Used in combination with I-LID ’N LASH® wipes or pump, creates a “One-Two Punch” for optimal cleansing of the lids and lashes.
Nutritional Supplements
The I-VU® line of omega-3 supplements help to provide relief and improve symptoms of dry eye disease, including support for proper tear function in adults. Omega-3s also have anti-inflammatory properties, which can help the glands in the eyes that are irritated due to the lack of tears. I-VU® OMEGA-3 PLUS (capsule supplement) and I-VU® OMEGA-3 (liquid supplement) provides patients with the most important Omega-3 fatty acids, EPA, DHA & DPA in the re-esterified form allowing for better absorption. In addition, the liquid supplement also provides the recommended daily dose of vitamin D and the overall health benefits of gamma-linolenic acid (GLA).
Punctum Plugs
Punctum plugs can also serve as an effective way to manage symptoms of dry eye. Punctum plugs are tiny biocompatible devices that are inserted into the tear duct to block drainage. By blocking the tear duct, tears are prevented from draining away too quickly. This ultimately increases the eye’s tear film and surface moisture to relieve dry eyes. Punctum plugs can be inserted in-clinic by an eye care professional. I-MED Pharma carries the I-PLUG® and the I-PLUG® FIT in a variety of sizes. Ask your eye care professional about this quick and simple in-clinic procedure to see if it’s right for you.
E>Eye IRPL® (Intense Regulated Pulsed Light) Treatment
E>Eye is a long-lasting dry eye treatment solution specifically designed for patients suffering from Meibomian Gland Dysfunction. It uses patented IRPL® technology that generates a new polychromatic pulsed light by producing perfectly calibrated and homogeneously sequenced light pulses. The sculpted pulses are delivered under the shape of regulated train pulses. The energy, spectrum and time period are precisely set to stimulate the meibomian glands to improve their function. IRPL® treatments can lead to an improvement in the function of the meibomian glands in a very short amount of time (approximately two hours) following the treatment. For optimal results, 3-4 treatment sessions are recommended.
Sjögren’s syndrome and dry eye disease are closely connected and can have major implications in one’s life. However, with the proper compliance to dry eye management protocol, patients can significantly reduce their discomforting symptoms. It’s important to consult a physician early on if you suspect you are suffering from Sjögren’s syndrome, as early diagnosis and treatment can help prevent further ocular damage.
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[1] Foundation, S. Patient survey results. Sjögren’s Foundation. https://sjogrens.org/understanding-sjogrens/resources/patient-survey-results
[2] Foundation, S. Understanding Sjögren’s. Sjögren’s Foundation. https://sjogrens.org/understanding-sjogrens
[3] McHenry, M. (2012, November 13). Sjögren’s syndrome. Top Doctors. https://www.topdoctors.co.uk/medical-dictionary/sjogren-s-syndrome#
[4] Foundation, S. Understanding Sjögren’s. Sjögren’s Foundation. https://sjogrens.org/understanding-sjogrens
[5] NHS. (2020, April 21). Sjögren’s syndrome. NHS choices. https://www.nhs.uk/conditions/sjogrens-syndrome/
[6] NHS. (2020, April 21). Sjögren’s syndrome. NHS choices. https://www.nhs.uk/conditions/sjogrens-syndrome/
[7] NHS. (2020, April 21). Sjögren’s syndrome. NHS choices. https://www.nhs.uk/conditions/sjogrens-syndrome/
[8] McHenry, M. (2012, November 13). Sjögren’s syndrome. Top Doctors. https://www.topdoctors.co.uk/medical-dictionary/sjogren-s-syndrome#
[9] Foundation, S. Dry Eye. Sjögren’s Foundation. https://sjogrens.org/understanding-sjogrens/symptoms/dry-eye
[10] Akpek, E. K., Bunya, V. Y., & Saldanha, I. J. (2019, May). Sjögren’s syndrome: More than just dry eye. Cornea. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482458/
[11] Bunya, V. Y., & Rodriguez De Los Reyes , R. A. (2023, March 12). Dry Eye in Sjogren’s syndrome. EyeWiki. https://eyewiki.aao.org/Dry_Eye_in_Sjogren%27s_Syndrome