First, suppose you have dry eye disease. In that case, it’s essential to see an eye doctor and your rheumatologist for a thorough evaluation. It’s not a good idea to attempt to self-treat your symptoms. Dry eyes can cause long-term damage if not treated correctly.
Inflammatory arthritis and other autoimmune disorders can cause other eye issues in addition to dry eye. You need a professional evaluation to figure out what’s behind your symptoms and how to treat them optimally.
Medication, lenses, devices
Commonly used to treat dry eye disease based on your medical condition.
Over-the-counter artificial tears
People with mild symptoms may be able to use over-the-counter eye drops, also known as artificial tears (they come in gel or ointment form), which can help lubricate the eyes.
Topical cyclosporine (Restasis) eye drops
A prevalent prescription that helps relieve inflammation in the eye, which can, in turn, help boost tear production.
Lifitegrast (Xiidra) prescription drops
Lifitegrast also helps reduce inflammation in the eye and is a common prescription for those with an autoimmune disorder and dry eye.
Corticosteroid drops
Your doctor may also recommend corticosteroid eye drops. Corticosteroids should not be used for long periods because this can increase the risk of vision-related side effects such as glaucoma and cataracts.
Eye inserts
These tiny inserts of the medication hydroxypropyl cellulose (Lacrisert) are like a slow-release version of artificial tears. Small inserts are to be placed in your eye (between your lower eyelid and eyeball) once a day.
Punctal plugs
Doctors put little plugs in the tear ducts — where the tears drain — to keep those tears around longer. While there are permanent punctal plugs, doctors commonly use the temporary variety.
Medication that stimulates tear production
A class of medication called cholinergic helps to promote tear production. Available in eyedrop, pill, or gel form. Names include pilocarpine (Salagen) and cevimeline (Evoxac).
Autologous blood serum drops
Autologous serum drops use components from a sample of your own blood, with vitamins and growth factors that more closely mimic real tears. They are essentially supercharged artificial tears because they have natural proteins and growth factors to help heal severe, dry eyes.
There are a few challenges with these — they are expensive, need to be specially made by drawing blood, need to be refrigerated, and expire pretty quickly. Because of all of these factors, we usually only recommend blood serum tears when more conservative measures fail.
Moisture chamber spectacles
These are specially outfitted glasses with a gasket or cup. Rests between the glasses frame and your face to help slow down the evaporation of tears by acting as a barrier against wind and other drying factors in the environment.
Scleral Contact lenses
Special contact lenses, called scleral contact lenses, are for people with bad ocular surface disease, such as chemical injury, burn, or graft-versus-host-disease. PROSE lens vaults over the cornea so that a well of fluid is always in contact with the eye. Not to be used routinely for Sjögren’s, except in very severe cases.
Tarsorrhaphy
Tarsorrhaphy is eyelid surgery to close the eyelid partially. Done for the eyelids don’t close properly, resulting in dry eyes. Dry eyes result from exposure to the outside environment.
Use of amniotic membrane
Human amniotic membrane (AM) — placed in the eye or as specialized contact lenses — can help treat severe dry eyes. The amniotic membrane has anti-inflammatory properties; however, it blurs the vision when it is in place. The benefit is usually not permanent, though a scratch on the cornea from severe Sjögren’s can promote healing.
Topical azithromycin
An antibiotic that helps particularly well with meibomian gland dysfunction (when there is a blockage of these glands) lowers the amount of oil secreted in tear production.