Dry eye may be a manifestation of an immune disorder.


Immune diseases associated with dry eye:

(1) Sjogren's syndrome

(2) secondary Sjogren's syndrome associated with

(2a) rheumatoid arthritis (RA)

(2b) systemic lupus erythematosus (SLE)

(2c) scleroderma

(2d) dermatomyositis

(2e) other rheumatologic disorder

(3) ocular involvement by an immune vesicobullous disorder

(3a) Steven-Johnson syndrome

(3b) ocular cicatricial pemphigoid

(3c) Lyell's syndrome (toxic epidermal necrolysis)

(4) graft vs host disease


The vesicobullous disorders can cause severe dry eye and corneal scarring with permanent visual impairment.


Primary and secondary Sjogren's syndrome tend to be mild to moderate without irreversible visual impairment.


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