View Full Version : Dry Eyes and Autoimmune Diseases from the Sjogren's Conference

04-12-2010, 09:13 PM
Here is report number 2.
Dry Eyes Stephen Cohen, OD

Dr. Cohen is an optometrist from Scottsdale, Az, so he sees lots of dry eyes. He is amazing – an optometrist who is “with it” enough to check for underlying autoimmune issues.

After explaining how the eye and tears work, he told us what symptoms should alert your eye specialist to do further testing for Sjogren’s.
• Symptoms increase as day progresses
• Sandy/gritty sensation
• Fatigue/heaviness
• Transient blur
• Itchiness
• Dryness
• Apparent Epiphora (reflex tearing in wind, cold)

Dr. Cohen said that blurring, or vision fluctuations, often late in the day, are often missed or misdiagnosed. In cataracts, the blur is more consistent. He explained all of the testing, such as the Schirmer test and Rose Bengal, with which many of us are familiar.
Here is what we wanted to know – treatments:
A. Topical There are many products on the market, known as artificial tears. We need to try them to see what works best for us personally. It is important that the product remain on the eye as long as possible without blurring. Preservatives can cause burning if they don’t evaporate quickly. Gels are recommended for night. He highly recommended Systane.

B. Immunomodulators & Anti-inflammatories Some NSAIDs and steroids are prescribed. Restasis is the only prescription available now, and he seemed to like it. It can cause burning, and the condition may seem to worsen for a while, but he urges patients to keep trying.

C. Surgical Options: Cautery – permanent, Punctal plugs – collagen, silicone and smart plug

D. Contact Lenses There are new materials and lubricating solutions that make these possible with dry eyes

E. Oral supplements He highly recommended fish oil and listed out supplements that contain fatty acids, viatamins A,C , E, flaxseed oil, etc.

F. Environmental protection These include warm compresses, lid massage, wearing wrap-around sunglasses, etc. We were shown a good new product called Tranquil Eyes, which he liked.

G. New or on the horizon: Topical Androgens to regulate quality and quantity of lipid secretions Autologous Blood serum – patient’s own blood is used to make an eye drop.

This optometrist encourages his patients to be informed and educated, find support groups, build a health care team and develop a health care mission plan.

1. Latest treatments? See Above
2. Are sinus problems, nasal polyps, dry nose, etc. related? Treatments? Yes to all of these, also mentioned in previous presentation.

I hope that this helps some of you who are dealing with this.

04-13-2010, 12:29 PM
thanks marla....i always thought my eye dryness and "heaviness" later in the day was caused by being tired....this is what i have been told for years....very interesting and informative. thanks again.

04-14-2010, 01:24 AM
Apparent Epiphora (reflex tearing in wind, cold)

So THAT'S what it's called and it is Sjogren's related. I get that one so bad! I can't stand it. Is there something for it?

Can anyone make a good suggestion for contact lenses? I tried Oasys along with a dry eye lubricant the doc gave me, forget what it was, this was years ago...and I was still miserable. I could only wear them comfortably for about an hour and then I couldn't stand them anymore. I would love to wear contacts...even if it's just for half a day. Are there any lenses out there that are more comfortable?

Thanks again Marla!

05-03-2010, 04:31 PM
Bumping this up for Sarah

05-03-2010, 05:33 PM
THank u!!! I will talk to the dr. tom morning. I apprecitae the info.!! U guys really are the best and most helpful!!