Lupus Advice Leaflet



Lupus Advice Leaflet

Managing Dry Eyes and Dry Mouth

Dryness (Sicca symptoms)

Dryness or sicca symptoms, varies from person to person and tends to affect the mouth, eyes, skin, and in women, the vagina.

Dry eyes can lead to eye irritation, resulting in a ‘gritty’ sensation, an increased risk of infections and in more serious cases, possibly abrasion to the dome of the eye (cornea).

A Schirmer’s test can be performed by your doctor or nurse in clinic to find out whether the eye produces enough tears to keep it moist. This is measured by sterile filter paper that is placed in the lower lid and the results are measured. Sometimes you may need to be referred to an eye specialist (an ophthalmologist) who may perform further investigations.

Treatments for severe dry eyes can include temporary punctal occlusion, where a plug is inserted to help maintain tears for longer (it prevents them running down your nose). This can dissolve within days and is only a short term solution. If necessary, cauterisation can be performed but this is permanent and usually irreversible.

Dry mouth can lead to an increased risk of dental decay, gum inflammations (gingivitis), oral thrush, mouth sores, swallowing difficulties and painful swelling and infection of the facial salivary (parotid) glands.

Living with Dry Eyes

Living with dry eyes is uncomfortable. There are a few simple things that can help you to better manage your eye symptoms, such as:

• Avoid dry atmospheres

• Humidify rooms

• Wear glasses with side arms

• Use appropriate tear replacements

o Hypromellose (preservative free), short acting

o Viscotears, longer acting

o Lacrilube (ointment), more effective at night

o If sticky (mucus/debris in eyes), mucolytic agents such as acetylcysteine

o Antibiotic eye drops if you have any signs of infection

Living with a Dry Mouth

Dry mouth is a difficult symptom to treat, but you may find some of the following suggestions useful:

• Try taking sips rather than ‘glugs’ of water

• Avoid sugared drinks

• Chew sugar-free chewing gum

• Try using saliva replacements, also gels, lozenges or pastilles

• Saliva stimulation tablets can help

• Take a spoonful of natural sugar free Greek yoghurt before you go to bed

• Review your medication list with your doctor as some medicines you take may worsen your dry mouth

Living with Other Dryness

Vaginal dryness can be managed with the use of simple lubricants such as KY jelly, hormonal moisturisers or oestrogen creams. Non hormonal creams e.g. Replens MD are also available. In some cases HRT may be prescribed and you would need to discuss this with your GP.

Sometimes your doctor may suggest trying a drug Pilocarpine to help with your sicca symptoms. This is a drug that stimulates saliva and sweating but unfortunately, in some people, this can lead to excess sweating, increased bronchial mucus secretion and a drop in blood pressure. For this reason, if the drug is prescribed for you, you will start at a low dose and it is increased slowly, dependent on your tolerance of any side effects.

Support for you

Sometimes it can help to talk to other people who experience similar symptoms.

Further advice can be obtained from:

British Sjogren’s Syndrome Association bssa.

0121 455 6532

Arthritis Research UK

0300 790 0400

Lupus UK .uk 01708 731251

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