Transcript
Announcer:
You’re listening to Living Rheum on ReachMD. On this episode, we’ll hear from Dr. Esen Akpek, who is Professor of Ophthalmology, Director of the Frances and C. Stephen Foster Center for Ocular Immunology and Inflammation, and Chief for the Division of Ocular Immunology at Duke University School of Medicine in Durham, North Carolina. She’ll be discussing the ocular manifestations of Sjögren's disease. Here’s Dr. Akpek now.
Dr. Akpek:
Normally, the eye surface and cornea are covered with a three-layer tear film, which serves to prevent desiccation, friction, and inflammation, but it also provides clarity for vision and trophic factors for cell growth and regeneration.
In Sjogren's disease, autoimmune inflammation causes impaired tear film stability, which leads to corneal and conjunctival inflammation and eventually decreased tear secretion. This is known as aqueous-deficient dry eye. However, many patients also have damage to the oil-producing meibomian glands in the eyelids. These glands produce an oily tear layer that is called meibum, which helps slow tear evaporation into air. So their function can worsen with dryness, and this is not uncommon in patients with Sjogren's.
The important point is that Sjogren's eye disease is not simply a lack of moisture. It's a combination of reduced tear production and unstable tear film, causing damage to the eye surface. This damage is subtle at first, and can only be determined using vital dye staining of the ocular surface. In earlier stages of the disease, surprisingly, patients do not experience significant symptoms. With more chronicity, burning, stinging, or gritty sensation, light sensitivity, eye fatigue, and fluctuating or blurred vision are common.
Although dry eye is the most typical ocular manifestation, Sjogren's can also lead to inflammation of deeper or other ocular tissues, causing non-infectious keratitis, uveitis, scleritis or episcleritis, optic nerve inflammation, and retinal inflammation. These conditions may be associated with systemic complications of Sjogren's, or they might occur in isolation. Unless aggressive immunomodulatory systemic treatment is initiated timely, these conditions can lead to blindness.
Announcer:
That was Dr. Esen Akpek talking about the impacts of Sjögren's disease on the eyes. To access this and other episodes in our series, visit Living Rheum on ReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!
