[Diagnosis and treatment of Sjogren's syndrome].

Filamentary Keratitis as Indication In their review on Sjögren’s syndrome (1), the authors Stefanski and co-workers highlighted the interdisciplinary care required for this serious chronic inflammatory autoimmune disease. In addition to subjective patient symptoms of eye irritations, including foreign body sensation, burning, stinging, and photophobia, objective signs can be very important for diagnosis; these include not only Schirmer’s test (as mentioned by the authors) but also superficial punctate keratitis and pronounced conditions of filamentary keratitis. For tearing deficiencies, as occur in sicca syndrome, not only a reduction of the aqueous phase of the tear film but also a disturbed lipid phase (meibomian gland dysfunction) and a reduced mucin phase (goblet cell dysfunction) should be taken into account (2). Despite intensive therapy with artificial tear drops, sicca syndrome can be so pronounced that it can lead to incapacity for work. DOI: 10.3238/arztebl.2017.0660a