Sjogren's syndrome as seen by an ophthalmologist

Ocular surface involvement is a frequent feature of Sjogren syndrome charac terized by the presence of typical symptoms such as burning and foreign bod y sensation and by wide spread epithelial damage of the cornea and on the c onjunctiva. There is now evidence that local inflammatory changes and lacrymal gland-de rived tear-borne pro-inflammatory agents have an important role in the buil d up and the maintenance, of ocular surface damage by the instauration of s elf maintaining vicious cycles. Inflammation causing decreased ocular surfa ce sensation, resulting in further decreased tear secretion and decreased t ear clearance, with growing concentration of pro inflammatory agents on the ocular surface. From the anatomic pathological point of view there is a not clarified discr epancy between the early highly depressed tear fluid production and the lim ited extension of involvement of the lacrymal gland. Proper gland stimulatory agents and control of inflammation could result in a better treatment than the palliative therapy available to day.