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Dry mouth and eyes? A possible cause is Sjögren’s syndrome

The lacrimal glands no longer produce tear fluid, the eyes begin to burn, and the oral mucosa dries out. This could already be a sign of Sjögren's syndrome, a form of rheumatism that affects, among other things, the mucous membranes of the eyes. But where does this disease come from and what can be done about it?

What is Sjögren’s syndrome?

Sjögren's syndrome is a special form of rheumatism that mainly affects the functions of the mucous membranes. It is regarded as an autoimmune disease in which the body's defences attack the lacrimal and salivary glands. The result is a chronic wetting disorder that leads to permanently dry eyes; a dry mouth is also a typical symptom.

Whereas most other rheumatic diseases affect bones, muscles, tendons or ligaments, Sjögren's syndrome is one of the rare forms of rheumatism that manifests itself through discomfort in the eyes. Women are affected significantly more often than men, which would suggest a connection with female sex hormones. Sjögren's syndrome is divided into two types:

  • Primary type: This is where Sjögren's syndrome occurs in isolation, in the absence of any other underlying disease.
  • Secondary type: Here, the disease of the eyes occurs in association with an underlying rheumatic disease, such as rheumatoid arthritis.

The disease is named after the Swedish eye specialist Henrik Sjögren, who first wrote about the clinical picture in his doctoral thesis in 1933.

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What is the cause of Sjögren's syndrome?

What is the cause of Sjögren's syndrome?

The exact causes are not yet clearly understood. Autoimmune reactions of the body are involved in many forms of rheumatic diseases, presumably also in Sjögren's syndrome. The immune system turns against the body’s own tissue – here against the mucous glands – causing the rheumatic symptoms.

This can affect tear production, on the one hand, so that not enough tear fluid is produced to lubricate the eyes. On the other hand, the composition of the tear film may also be disturbed so that the tear film ruptures prematurely. Possible causes include:

  • hereditary predisposition
  • harmful environmental influences
  • smoking
  • stress
  • chronic viral infections

What are the symptoms of Sjögren's syndrome?

The main symptoms are a dry mouth and dry eyes. These manifest themselves in various symptoms resulting from the inadequate tear film:

  • a feeling of grit in the eyes
  • a constant burning and itching
  • a feeling of pressure and pain with each blink
  • visual impairment, blurred vision
  • sensitivity to light
  • inflammation of the gums and oral mucosa
  • drying out of the nasal mucosa or the mucosa of the throat and bronchial tubes

In the majority of cases, Sjögren’s syndrome makes itself known only by mild symptoms which, however, become progressively worse. With time, the dryness in the mouth and eyes can even become unbearable. In severe cases, tear production even stops altogether, because the glands are completely destroyed by the autoimmune reaction. It is all the more important to consult an eye specialist when noticing the first signs so that treatment of the symptoms can commence as quickly as possible.

What can I do about Sjögren’s syndrome?

Sjögren’s syndrome is currently not treatable causally and is therefore regarded as incurable. However, the eyesymptoms can be relieved. This is usually achieved with lubricating eye drops which stabilise the tear film. They need to be instilled into the eyes several times a day to ensure sufficient protection throughout the day. If the dry eyes remain untreated, there is a risk of severe consequences, such as corneal damage, eye infections and even the complete loss of vision.

The doctor will also suggest suitable treatment for the body’s other mucous membranes, such as those of the nose, the windpipe, the bronchial tubes or the genitals.

Also interesting: Conjunctivitis – causes and treatment

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What medications help against Sjögren's syndrome?

The deficient or absent tear film can be maintained by using lubricating eye drops, gels or ointments. Eye drops are often sufficient for mild symptoms, while gels and ointments are more suitable for chronic and more severe symptoms. They remain adherent to the surface of the eye for longer due to their composition and consistency and give the eye lasting protection.

Another option is surgery, where the doctor closes the tear ducts in an operation so that the small amount of tear fluid which is still produced by the glands does not drain away.