How do I know if I have Sjoren's?

[tiff]

Hi,
I'm 33, female, have dry eye, mgd, ocular rosacea, and blepharitis. I've had two rounds of routine bloodwork to check for autoimmune issues and both times they came back very good. I've been on doxy for 3.5 months, restasis for 3 months, artificial tears, do lid scrubs, warm compresses, wear sunglass goggles, and take omega supplements. Things have improved a little (mostly the grittiness), but one of my docs suggested maybe I have Sjoren's. I don't know if I have dry mouth (mouth feels the same it always has), but my dentist said if I did I would have cavities and I've never had any. I was on birth control for 11 years and have learned that can be the culprit for dry eye. But, I am wondering whether I should have further blood testing to see if I have Sjoren's. Any thoughts? Also, does it matter what caused these issues for me, would we treat them differently if it was from Sjoren's? I have no other symptoms besides the eye issues.
Thanks so much,
Tiffanys

[kitty]

Sjogrens can be diagnosed by a biopsy of the tissue inside of your lip. Your GP should be able to do that for you.

[pecan121]

If you have Sjogren's, a rheumatologist would probably put you on meds to keep your condition from getting worse. I am on mobic for pain and inflammation and plaquenil. Unfortunately, there is nothing specific for dry eye. If you have Sjogren's your doctor will want to check your blood periodically and physically check your joints and lymph nodes.

If you have a diagnosis for Sjogren's, I think eye doctors pay more attention to you; it gets your out of the "run of the mill" dry eye category. Maybe I am just more proactive since I have a diagnosis. All of us need to do our own research and ask for what we want. If a doctor tells us "no" he needs to explain why.

[tiff]

thanks kitty and pecan.

pecan, how did you know you had sjoren's? did you have the lip biopsy?

thanks,
tiffany

[pecan121]

No, I did not have the lip biopsy. My blood tests showed I was positive for both Sjogren's antibodies. You can have Sjogren's even if the antibodies haven't shown up yet.

Before you have the biopsy read all the posts on the forum. I think there is one method that is easier on the patient but I can't remember what it is.

[y-gwair]

Hi,
I'm 33, female, have dry eye, mgd, ocular rosacea, and blepharitis. I've had two rounds of routine bloodwork to check for autoimmune issues and both times they came back very good...But, I am wondering whether I should have further blood testing to see if I have Sjoren's.

Hi, sorry to hear you are worried you may have Sjogren's. A lot of people get referred for Sjogren's because of combined dry mouth/eyes, but this doesn't necessarily mean they have Sjogren's; most end up being categorised as having something called Sicca Syndrome (sicca just means dryness) which may have many different causes (hormones, thyroid disease, anaemia, depression or just ideopathic).

Diagnosis of Sjogren's is mainly established by testing for anti-Ro/La antibodies ( also know as SSA and SSB). Unfortunately, Ro/La is only positive in something like 2/3rds of cases, so lip biopsy is usually only done if the antibody tests have come back negative. My rheumatologist asked for immunoglobulins in addition to Ro/La. Also a test for thyroid function/antibodies and anaemia as both of these conditions can cause symptoms very similar to Sjogrens, and need to be excluded.

The pattern of dental caries for dry mouth/Sjogren's is different from general decay; holes in the enamel tend to appear either low on the gumline or along the edges of the incisor teeth. Your dentist should also be able to tell you if your saliva is normal from it's appearance, as well as volume. I'm sure your dentist would have noticed if you had a significant problem (mine did).