eMedicine Specialties > Ophthalmology > Connective Tissue Disorders

Sjogren Syndrome: Follow-up

Author: James V Aquavella, MD, Professor of Ophthalmology, Department of Ophthalmology, University of Rochester School of Medicine, University of Rochester Eye Institute
Coauthor(s): Zoe R Williams, MD, Staff Physician, Department of Ophthalmology, University of Rochester School of Medicine, Strong Memorial Hospital; Shobha Boghani, MD, Assistant Professor, Department of Ophthalmology, Strong Memorial Hospital, University of Rochester
Contributor Information and Disclosures

Updated: Feb 19, 2008

Follow-up

Further Outpatient Care

  • Patients should receive follow-up care as needed.

Deterrence/Prevention

  • Wearing spectacles or goggles is beneficial in preventing ocular surface drying secondary to exposure.
  • The placement of air conditioning or heating ducts at home and at the workplace should be considered.
  • Avoidance of desiccating environments, such as proximity of open fireplaces or smoke-filled rooms, should be considered.
  • Systemic medications also can adversely affect the ocular surface. Reduction or elimination of such medications could decrease the drying of the ocular surface.

Complications

  • Severe dry eyes can cause corneal scarring, ulceration, infection, and even perforation.

Prognosis

  • While the prognosis is good for most patients, eyes with corneal infection, ulceration, or perforation have a much more guarded prognosis.

Patient Education

  • Patients should know to seek ophthalmic care if their eyes become red or painful, or if they develop a mucopurulent discharge.
  • For excellent patient education resources, visit eMedicine's Arthritis Center. Also, see eMedicine's patient education article Sjögren Syndrome.

Miscellaneous

Medicolegal Pitfalls

  • In any of these individuals who are treated with immunosuppression, it is extremely important that the ophthalmologist be aware of the patient's status regarding follow-up laboratory studies. It is also important for these patients to have contact with their internist and/or immunologist. This should be noted clearly on the medical record at each patient visit.
  • If nonpreserved medications and/or hydrophilic bandage lenses are used, one must always be aware of the significant potential for secondary infection. These risks should be explained to the patient prior to initiating these forms of therapy. The use of a prophylactic antibiotic is the standard of care.
  • In the presence of a significantly compromised ocular surface, there is some reluctance to use topical anesthetic and applanation tonometry. While the intraocular pressure recording may not be necessary at each particular visit, it should clearly be performed and its results indicated on the chart at periodic intervals. Additionally with the anterior segment ocular surface disorder, routine follow-up care of the posterior segment also may be compromised. Care should be taken to perform either dilated fundus examinations or, at the very least, fundus examinations without dilatation at intervals that are appropriate for the patient's age and general status.
 


More on Sjogren Syndrome

Overview: Sjogren Syndrome
Differential Diagnoses & Workup: Sjogren Syndrome
Treatment & Medication: Sjogren Syndrome
Follow-up: Sjogren Syndrome
References
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Further Reading

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Keywords

SS, keratoconjunctivitis sicca, KCS, xerostomia, dry mouth, dry eyes, autoimmune disorder, rheumatoid arthritis, systemic lupus erythematosus

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Contributor Information and Disclosures

Author

James V Aquavella, MD, Professor of Ophthalmology, Department of Ophthalmology, University of Rochester School of Medicine, University of Rochester Eye Institute
James V Aquavella, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, American Medical Association, Contact Lens Association of Ophthalmologists, and International College of Surgeons
Disclosure: Nothing to disclose.

Coauthor(s)

Zoe R Williams, MD, Staff Physician, Department of Ophthalmology, University of Rochester School of Medicine, Strong Memorial Hospital
Zoe R Williams, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Shobha Boghani, MD, Assistant Professor, Department of Ophthalmology, Strong Memorial Hospital, University of Rochester
Shobha Boghani, MD is a member of the following medical societies: American Academy of Ophthalmology and Contact Lens Association of Ophthalmologists
Disclosure: Nothing to disclose.

Medical Editor

Fernando H Murillo-Lopez, MD, Senior Surgeon, Unidad Privada de Oftalmologia CEMES
Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Christopher J Rapuano, MD, Professor, Department of Ophthalmology, Jefferson Medical College; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Hospital
Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, Eye Bank Association of America, Pennsylvania Medical Society, and Philadelphia County Medical Society
Disclosure: Nothing to disclose.

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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