Dry Eye May Signal Underlying Disorder

Symptoms raise red flag, lead to referral to rheumatologist and diagnosis of Sjogren’s syndrome.

Diane Dupuis is naturally creative. For nearly 20 years, she owned a floral design business in New York City. She specialized in artificial plants, with which she decorated the lobbies of hotels, banks and offices. The idea for her business had its roots in her native Washington state.

Diane’s combination treatment has her feeling as “close to normal” as she’s been since she was young.

“While I was living in Seattle, I worked with a friend who was a designer for a big company,” elaborates Diane, 73. “She trained me in floral design. When I moved east, I opened my own shop. I began making artificial trees for clients. Some of those trees were 20 to 25 feet tall.

“I also worked with fresh flowers and did weddings and other events, which was really fun. I took some interior design courses in New York and started doing that as well. I helped change the decor in a few doctors’ offices, banks and other businesses to make them look fresher and more inviting. I loved making things look beautiful.”

Diane retired about 15 years ago, eventually relocating to Florida. Unfortunately, eye discomfort interrupted her idyllic life in the Sunshine State. Her problem was dry eye disease, a common condition in which the eyes fail to produce the right quantity or quality of tears to stay sufficiently lubricated.

“I’ve always had pretty good eye health, but for the last 10 years or so it’s been very bad,” Diane laments. “My eyes were extremely dry and felt terrible. They burned and stinged. The discomfort was constant, a 10 on a scale of one to 10.

“I love to read, but the pain was so bad that it hurt to read. And if I woke up in the middle of the night, I couldn’t shut my eyes again because they were so dry. I had to massage them and put drops in them to get them shut.

“I didn’t look like myself, either. Normally, I have big eyes, but they became little slits. I could barely see out of them. It hurt to open my eyes. I couldn’t enjoy anything because my eyes hurt all the time.”

Diane eventually sought treatment from a physician who claimed to be a dry eye specialist, but Diane was highly dissatisfied with the care.

“He treated me for nearly three years and never even tested my eyes,” Diane declares. “I finally begged him, Could you please just do a Schirmer’s test? That’s a little strip they put in your eye to see if it’s making enough tears to stay moist. When the results came back showing I had severe dry eye, the doctor said, I couldn’t tell your eyes were dry.

When Diane’s symptoms failed to improve with that physician’s treatment approach, she followed a friend’s recommendation and visited Dr. Jenifer Ramsower, founder of Dry Eye Center of Florida, the only practice in Central Florida dedicated to the diagnosis and treatment of dry eye disease.

Autoimmune Disorder

“Ms. Dupuis suffered for many years with dryness, burning, fatigue and pain in her eyes, so we performed our extensive dry eye workup on her,” Dr. Ramsower recalls. “That workup included advanced diagnostic testing on the ocular surface and a questionnaire about symptoms, medications and other health conditions. It helped guide us in our treatment approach.

“On her questionnaire, Ms. Dupuis noted some unusual symptoms that raised a red flag for me. They included dry mouth, gastrointestinal distress, inability to concentrate and muscle weakness. Their presence prompted me to perform additional tests to look for a potential cause.”

The additional tests pointed to an underlying systemic disorder. After learning the test results, Dr. Ramsower referred Diane to a rheumatologist for further testing and a definitive diagnosis.

“The rheumatologist discovered Ms. Dupuis suffered with Sjögren’s syndrome,” Dr. Ramsower reports. “Sjögren’s is an autoimmune disease that typically causes dry eyes, dry mouth, fatigue and muscle weakness. It is often discovered by dry eye specialists because of the advanced testing performed on the ocular surface and tear film.”

Dr. Ramsower worked closely with the rheumatologist to coordinate care, which included anti-inflammatory eyedrops and a daily eye scrub to remove debris from Diane’s eyelashes that was contributing to the dry eye symptoms.

“We also inserted tiny plugs, called punctal plugs, into the tear ducts to increase the amount of tears on the front surface of her eyes,” Dr. Ramsower explains. “Her rheumatologist prescribed an oral medication to calm the inflammation due to the Sjögren’s. The combination treatment greatly improved her quality of life.”

“The Pain Is Gone”

That improvement came quickly, according to Diane.

“Within three months, I felt almost normal again,” she enthuses. “Today, I’m as close to normal as I’ve been since I was young. How I feel now just doesn’t compare to how I was feeling before. The difference is absolutely amazing.

“The pain is gone. It’s not even a one or two out of 10. And, I have no trouble sleeping at night. Even if I do wake up, I don’t have to massage my eyes or put drops in them to shut them.

“For the first time in years, I’m not constantly thinking about my eyes, and that’s thanks to Dr. Ramsower, who is just adorable. Not only is she sweet, but her whole staff is sweet. They are the kindest people ever, and they keep a very clean office, which I greatly appreciate. I recommend Dr. Ramsower and Dry Eye Center of Florida 100 percent.”

© FHCN article by Patti DiPanfilo. Photo by Jordan Pysz. mkb
Print This Article
    • Dry Eye Center of Florida

      Dr. Jenifer Ramsower is committed to the advanced diagnosis and treatment of dry eye. Dry eye is a chronic and progressive condition that affects millions. Recent research into the causes of dry eye and the importance of maintaini... Read More

    • Jenifer Ramsower, OD

      Jenifer Ramsower, OD, earned her Bachelor of Science degree in life science and her Doctor of Optometry degree with honors from Nova Southeastern University in Fort Lauderdale.  She completed a residency in ocular disease at the Baltimore VA Me... Read More