Treatment of Sjögren Syndrome with Ocular Dryness or Abnormal Ocular Tests

This protocol applies to patients with Sjögren syndrome who present with ocular dryness and/or abnormal findings on ocular testing — a specific clinical scenario that warrants a defined management pathway.

Clinical scenario: Sjögren syndrome with ocular dryness or abnormal ocular tests. Symptom burden and objective ocular findings guide the selection and escalation of interventions within this protocol.

Treatment approach (partial)

When symptoms persist, rescue therapies — including oral muscarinic agonists — may be considered for subjective ocular symptoms. The complete protocol covers additional options and the full sequencing.

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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.

Other therapeutic interventions may be considered after failure of the above-mentioned therapies, including topical and systemic therapies.

With respect to systemic therapies, oral muscarinic agonists may be considered on the basis of the improvement of subjective (not objective) ocular outcomes.

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