Health Questions and Answers

Question: How does one document keratoconjunctivitis sicca?

Answer:

Many believe that Sjögren’s syndrome is underdiagnosed. The first step is to ask the appropriate historical questions. Inquiries about eye grittiness or the ability to eat crackers without water have been suggested as nonleading ways to ask about dryness. Schirmer’s test can document diminished output of the lacrimal glands. Likewise, biopsy of the salivary glands (usually in the lower lip), showing the presence of infiltrating lymphocytes, establishes the diagnosis.

Reference: Talal N: Sjögren’s syndrome and connective tissue diseases association with other immunologic disorders. In McCarty DJ, Koopman WJ (eds): Arthritis and Allied Conditions, 12th ed. Philadelphia, Lea & Febiger, 1993, pp 1343-1356.

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