Dry Eye and Mood: Unveiling the Link in Sjögren's Syndrome
"Could your dry eyes be affecting your mental well-being? New research highlights the psychological impact of dry eye disease in patients with primary Sjögren's syndrome."
Primary Sjögren's syndrome (pSS) is a chronic autoimmune disease primarily affecting moisture-producing glands, leading to dry eyes and dry mouth. While the physical symptoms are well-recognized, the impact of pSS extends beyond the body, significantly affecting patients' mental and emotional health.
A recent study highlighted how pSS could significantly impair the quality of life (QoL) of patients, emphasizing the importance of measuring QoL in comprehensive disease management. However, an important factor is often overlooked: the role of dry eye disease (DED) in influencing psychological status and overall quality of life in pSS patients.
This article explores the potential link between dry eye disease and psychological well-being in individuals with primary Sjögren's syndrome, shedding light on the importance of considering and managing dry eye symptoms as part of a holistic approach to patient care.
Current Impact
Dry eye is a prominent feature of Sjögren’s syndrome because the disease affects the lacrimal glands and can disrupt the ocular surface. Its effects may extend beyond eye discomfort, influencing daily well-being and emotional health. However, the available material here does not provide specific prevalence figures or quantified mood outcomes.
Current Management
Current management of Sjögren’s syndrome dry eye remains challenging because symptoms and clinical findings can overlap with other forms of dry eye, while extensive lacrimal-unit damage may resemble other severe disease. A 2020 review reported that many treatment options exist, but high-level efficacy evidence and evidence-based treatment algorithms are largely lacking. Tear proteomics using flush tears, standardized sampling, and lactoferrin-corrected analysis has been described as a promising approach for monitoring SS-related dry eye. A 2026 study is also evaluating a chronic disease management framework that includes implementation strategies, psychological outcomes, and practical nursing insights.
Historical Foundations
Historical records indicate that symptoms now associated with Sjögren’s disease were described before Henrik Sjögren. In 1871, W.B. Hadden and J.W. Hutchinson reported a case involving both dry eyes and dry mouth. Publications from the late 1890s through the early 1900s described simultaneous ocular and oral dryness, sometimes alongside chronic rheumatism or gout. Henrik Sjögren later encountered a 49-year-old woman with arthritis and extreme dryness of the mouth and eyes and presented 19 similar cases in his 1933 doctoral thesis.
The Overlooked Impact of Dry Eye Disease on Mental Health
Dry eye disease, a common manifestation of pSS, involves autoimmune destruction of the lacrimal gland and subsequent ocular surface damage. This can lead to a range of uncomfortable symptoms, including dryness, grittiness, pain, and blurred vision. But the impact doesn't stop there.
- Autoimmune destruction of lacrimal glands causes dry eye in pSS.
- Dry eye symptoms include discomfort, pain, and vision problems.
- DED is linked to depression, anxiety, and stress.
- Dry eye symptoms can worsen the mental health of pSS patients.
Emerging Research
Recent research is examining both new treatments and improved ways to understand Sjögren’s-related dry eye. A 2026 paper systematically evaluates the efficacy and safety of stem cell-based therapies for dry eye caused by Sjögren’s syndrome. Other reviews describe interconnected pathological changes that may create a reinforcing cycle of ocular-surface damage and explore future non-invasive diagnostic criteria and therapies. Diagnostic work is also investigating serum, salivary, and tear biomarkers, including proteomic and exosomal markers, while a separate systematic study is evaluating cyclosporine A for efficacy and safety.
Evidence Gaps
The available evidence does not support treating every proposed intervention as established care. Research in Sjögren’s-related dry eye remains limited by incomplete high-level evidence and the absence of consistently evidence-based treatment algorithms. Diagnostic uncertainty can also persist because symptoms and signs may overlap with other dry-eye conditions. These limitations make conclusions about effectiveness, long-term benefit, and broader psychological impact necessarily cautious.
Sjögren’s Versus Other Dry Eye
Studies have specifically compared Sjögren’s-related dry eye with non-Sjögren’s dry eye, including treatment patterns and long-term outcomes at the Johns Hopkins Wilmer Eye Institute’s tertiary Ocular Surface Disease and Dry Eye Clinic. Another study examined whether combinations of dry-eye signs and symptoms could distinguish Sjögren’s from other causes, reflecting the fact that no single test diagnoses dry eye disease. The comparative literature therefore emphasizes the importance of differentiating the conditions. It also supports targeted management rather than assuming that all dry-eye presentations are clinically interchangeable.
A Call for Comprehensive Care
Given the complex interplay between dry eye disease and mental health in Sjögren's syndrome, it's crucial for healthcare professionals to adopt a comprehensive approach to patient care. This includes not only assessing and managing the physical symptoms of dry eye but also evaluating the patient's psychological status and quality of life.
Integrated Perspective
Sjögren’s-related dry eye is best understood as a complex condition involving ocular symptoms, diagnostic challenges, and uncertain treatment evidence. The available material suggests that management must account for both eye-specific disease and the broader experience of living with an autoimmune disorder. Because evidence and individual presentations vary, clinical decisions should be individualized and interpreted cautiously.
Future Therapies
Future work is focused on developing therapies for a disorder that primarily affects the salivary and lacrimal glands and typically causes dryness of the mouth and eyes. The Sjögren’s Foundation reports that potential treatments are now in clinical trials, creating hope for meaningful relief. EyeWorld coverage likewise describes ongoing attention to the diagnosis journey, available treatments, and future hopes for patients. These developments suggest a research landscape moving beyond routine symptom management, although the eventual benefits remain to be established.
Systemic Context
Sjögren’s disease is a systemic autoimmune condition whose major dryness symptoms commonly involve the eyes and mouth. Dry eyes are identified as a major symptom, and ocular care is therefore an important part of living with the disease. This broader context means that dry-eye management should be considered alongside the disease’s effects on other parts of the body.
Living With Dry Eye
Persistent dry-eye symptoms in Sjögren’s syndrome may affect daily comfort and overall quality of life, while mood can be part of the lived experience of chronic illness. The available material does not provide specific patient-reported statistics or detailed accounts of these effects. A careful discussion should therefore recognize the potential burden without assigning unsupported levels of psychological impact.
Future studies should incorporate both objective measures of dry eye (tear film break-up time, Schirmer score, ocular staining) and subjective symptom assessments (discomfort, pain, dryness, grittiness) to gain a more complete understanding of the impact of DED on QoL in pSS patients. Such integrated analyses will be invaluable for determining the true burden of the disease and developing targeted interventions.
By acknowledging and addressing the psychological impact of dry eye disease, healthcare providers can significantly improve the overall well-being and quality of life for individuals living with primary Sjögren's syndrome.