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Chapter-06 Aqueous Tear Deficiency and Sjögren\'s Syndrome

BOOK TITLE: Atlas and Text of Corneal Pathology and Surgery

Author
1. Dokey Adrian
2. Akpek Esen K
ISBN
9789962678335
DOI
10.5005/jp/books/11349_6
Edition
1/e
Publishing Year
2011
Pages
12
Author Affiliations
1. The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
2. The Wilmer Eye Institute, Jerome Greene Sjögren's Syndrome Center, Johns Hopkins University school of Medicine, Baltimore, Maryland, USA
Chapter keywords

Abstract

Sjögren’s syndrome is a chronic autoimmune disorder characterized by immune-mediated destruction of the salivary and lacrimal glands, with subsequent development of xerostomia and keratoconjunctivitis sicca. SS is a multi- system disorder that can demonstrate cutaneous, vascular, hematologic, respiratory, renal, hepatic, and neurological involvement. SS may present as a primary disorder, or it can be secondary to other well-defined autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosis, polyarteritis nodosa, Wegener’s granulomatosis, systemic sclerosis, primary biliary sclerosis, mixed connective tissue disease or occult thyroid eye disease. Dry eye syndrome refers to a collection of disorders that produce characteristic tear film abnormalities leading to inflammation and discomfort symptoms with subsequent damage to ocular surface. While the causes of DES are diverse, they can be classified as fundamentally tear deficient or evaporative disorders. DES is a characteristic manifestation of SS resulting from autoimmune insult to the lacrimal gland. In this context, the exocrine function of the lacrimal apparatus is impaired. Therefore an aqueous tear deficiency is the primary mechanism behind the keratoconjunctivitis sicca. The decrease in tear production is accompanied by other ocular surface changes seen with DES, including increased osmolarity of the tear film and inflammation of the ocular surface.

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