While diagnostic testing for dry eye disease (DED) in Sjögren's syndrome (SS) is well described, the same cannot be said for monitoring the disease, as it’s not uniform across and between academic and private practice sites in North America.

A multi-centered retrospective study analyzed 123 SS charts to describe the customary practices at six North American sites in the monitoring of DED in SS. Although DED symptoms were the most common chart entry (98.4% of charts), the absence of standardized DED questionnaires was noteworthy.

The next three frequently recorded variables were meibomian gland dysfunction (76.4% of charts), corneal staining with fluorescein (75.6%) and anterior blepharitis (73.2%).

Private practice sites were more likely to use symptom questionnaires and grading scales and to describe anterior blepharitis, while academic sites were more likely to record tear break-up time (TBUT) and tear meniscus height.

The lack of standardized symptom assessment, wide differences in ocular surface stains and scales, and lack of tear flow assessment overall concerned researchers considerably.

Researchers suggested applying the Tear Film and Ocular Surface Society’s Dry Eye Workshop II report’s recommended testing protocol to a large group of SS patients to test the proscribed testing’s validity in the unique group of dry eye patients. They also called for standardization of ocular staining scales.

The authors concluded that creating universally accepted standards of testing would improve the ability of clinicians and researchers to communicate and understand the course of DED in SS.

Acs M, Caffery B, Barnett M, et al. Customary practices in the monitoring of dry eye disease in Sjögren’s syndrome. J Optom. July 17, 2018. [Epub ahead of print].