Royal College of Surgeons in Ireland
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Relationship between clinical parameters and quality of life in primary Sjögren's Syndrome: a prospective study

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posted on 2023-01-24, 07:42 authored by Emily Greenan, Q Pilson, Joan Ni Gabhann-DromgooleJoan Ni Gabhann-Dromgoole, Conor MurphyConor Murphy

Objectives: To quantify the impact of dry eye disease (DED) on health and vision related quality of life (HR-QOL, VR-QOL) in patients with Primary Sjögren's Syndrome (pSS).

Methods: Thirty-four participants with a confirmed diagnosis of pSS as per the 2016 ACR EULAR criteria participated. Main outcome measures included ocular surface parameters and HR-QOL and VR-QOL questionnaires. Clinical examination included visual acuity, Schirmer I testing, ocular surface staining (OSS) and measurement of tear film breakup time. The questionnaires included Ocular Surface Disease Index, National Eye Institute Visual Function Questionnaire-25, Short Form-36 (SF-36) and EULAR Sjogren's Syndrome Patient Reported Index.

Results: Despite the majority of participants (28 female, 6 male, mean age 61.3 years) having attained LogMAR 0.3 or better visual acuity, participants scored low on VR-QOL measures, representing DED related fluctuation in functional vision. All participants suffered from moderate to severe DED. OSS did not correlate with DED symptoms or QOL parameters. Lubricant usage and symptom severity had a statistically moderate to strong negative correlation with VR-QOL and HR-QOL. This was most evident in relation to physical and physiological wellbeing. Compared with normative data, participants had a lower HR-QOL in all scales of the SF-36 ((MD = 9.91 ± 5.16); t(7) = 5.43, p = 0.001).

Conclusions: Participants with pSS have a lower perceived QOL especially in relation to physical and mental wellbeing, correlating to severity of DED symptoms and treatment burden. Clinical signs do not align with symptoms. Therefore, clinicians should remain cognisant, adjusting treatment in accordance with patient reported perceptions.


The Royal Victoria Eye and Ear Hospital Research Foundation

Irish College of Ophthalmologists/Novartis Eye Research Bursary

IReL Consortium



The original article is available at

Published Citation

Greenan E, Pilson Q, Ní Gabhann-Dromgoole J, Murphy CC. Relationship between clinical parameters and quality of life in primary Sjögren's Syndrome: a prospective study. Eye (Lond). 2023

Publication Date

19 January 2023

PubMed ID



  • Ophthalmology
  • School of Pharmacy and Biomolecular Sciences


Nature Publishing Group


  • Published Version (Version of Record)