Treatment of Sjögren Syndrome with Ocular Dryness or Abnormal Ocular Tests
Sjögren syndrome patients who present with ocular dryness and/or abnormal ocular test findings require a focused, ophthalmologist-guided approach to managing ocular surface involvement. This protocol addresses that specific clinical situation.
The Specific Situation
This protocol applies when a patient with Sjögren syndrome has confirmed ocular dryness or objective abnormalities on ocular testing. Ocular surface involvement in Sjögren syndrome calls for dedicated management guided by both symptom burden and objective signs.
Treatment Approach
When ocular surface inflammation is present or suspected, a short-term course of topical ocular anti-inflammatory therapy — prescribed and supervised by an ophthalmologist — may be considered as part of the management strategy.
The complete structured regimen, including agent selection, sequencing, and monitoring guidance, is available through the full protocol.
References
DOI: 10.1136/annrheumdis-2019-216114
We recommend that all SjS patients presenting with ocular dryness and/or abnormal ocular tests should use AT containing methylcellulose or hyaluronate at least twice daily, with the frequency increased to as often as hourly, as indicated by symptoms and/or objective signs.
Topical ocular non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids may be prescribed by ophthalmologists as a short-term therapeutic approach (maximum 2–4 weeks), as adverse events may occur with continued use of topical NSAIDs (corneal-scleral melts, perforation, ulceration and severe keratopathy) or topical corticosteroids (infections, increased intraocular pressure and worsening/development of cataracts).