What is
Sjögren's Syndrome?
Sjögren's syndrome is an autoimmune condition where the immune system mistakenly attacks the body’s own tissues and cells. [1]
The age of onset and diagnosis for Sjögren's is typically in the 40s and 50s, and it predominantly affects women. Although, with increased education about Sjögren's, many patients are being diagnosed at a younger age. [2, 3]
Sjögren's Syndrome and dry eyes
Sjögren's syndrome often affects tear and saliva glands first, causing inflammation that disrupts moisture production and continuous lubrication.
Hence, the two most common symptoms are chronic dry eyes and dry mouth. [1]
Treatment
In Sjögren's, a typical starting point for dry eye management is the use of lubricating eye drops. Preferably, lubricating eye drops that are preservative free and phosphate free, especially for those applying multiple drops a day.
Staying on the safe side
Severe dryness of the cornea can result in inflammation and damage to the corneal cells. As with any injury, corneal cell damage should be carefully treated only with safe and optimal components.
For this reason, modern-day eye lubricants are preservative free and phosphate free, to avoid any complications and to promote the necessary conditions for healing.
Preservative Free
Preservatives can damage the cells of the eye surface, destroy the natural tear film, and be the cause of intolerance reactions.
Phosphate Free
Phosphates buffers can form insoluble crystals due to the reaction with calcium (which is released from damaged cells of the eye surface). These crystals can impair your vision.
Citrate vs. Phosphate
A safe and beneficial alternative to phosphate buffers is a citrate-buffered system. Citrate, as opposed to phosphate, does NOT form insoluble crystals while still maintaining a tolerable pH level.
Apart from avoiding unwanted complications,
citrate buffers have been shown to have a positive effect on wound healing.
References: 1. Fox RI. Sjögren's syndrome. Lancet. 2005 Jul 23-29;366(9482):321-31. doi: 10.1016/S0140-6736(05)66990-5. PMID: 16039337. 2. Anquetil C, Hachulla E, Machuron F, Mariette X, Le Guern V, Vittecoq O, Dernis E, Larroche C, Dubost JJ, Perdriger A, Devauchelle-Pensec V, Fauchais AL, Morel J, Dieudé P, Rist S, Sene D, Gottenberg JE, Hatron PY. Is early-onset primary Sjögren's syndrome a worse prognosis form of the disease? Rheumatology (Oxford). 2019 Jul 1;58(7):1163-1167. doi: 10.1093/rheumatology/key392. PMID: 30561748. 3. Mavragani CP, Moutsopoulos HM. The geoepidemiology of Sjögren's syndrome. Autoimmun Rev. 2010 Mar;9(5):A305-10. doi: 10.1016/j.autrev.2009.11.004. Epub 2009 Nov 10. PMID: 19903539.