Severe Ocular Manifestations In Sjögren’S Syndrome: A Case Report

This report presents the case of a 64-year-old woman diagnosed with Sjögren's syndrome, focusing on the progression of ocular manifestations, the diagnostic process, and the effectiveness of various treatment approaches. The report highlights the challenges in managing ocular complications associated with the disease, particularly keratopathy, entropion, trichiasis, and corneal ulceration.

1. Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

2. Student Scientific Association at the Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland

The clinical evaluation included an ophthalmologic assessment with Schirmer’s test for tear production and serological testing for SS-A antibodies to confirm Sjögren’s syndrome. The patient underwent pharmacological and surgical treatment to manage symptoms and various surgical interventions. These procedures included eyelash removal using mechanical and surgical methods, amniotic membrane transplantation for corneal epithelial defects, blepharoplasty to correct entropion, lacrimal puncta closure to improve tear retention, and cataract surgery to address visual impairment.

The patient was initially diagnosed with early-stage cataract, corneal ulceration, and right lower eyelid entropion. Despite treatment, improper eyelash growth recurred, affecting both eyes. Over time, she developed keratopathy, advanced cataract, and trichiasis, requiring multiple surgical interventions. Despite pharmacological and surgical management, conjunctival adhesions and vascularized corneal leucoma in the right eye led to persistent ocular morbidity.

This case report highlights the progressive nature of ocular complications in Sjögren’s syndrome and emphasizes the importance of early diagnosis and aggressive management to delay disease progression and prevent irreversible ocular damage. Despite intensive treatment, the patient experienced persistent ocular morbidity, underlining the need for ongoing multidisciplinary care. The study demonstrates that pharmacological and surgical interventions are crucial but may not fully halt the disease progression, necessitating long-term monitoring and management.