**The Risk of Infection in Dry Eye Syndrome Accompanying Primary Sjögren's Syndrome**

Maria Maślińska and Brygida Kwiatkowska

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/64243

#### **Abstract**

Primary Sjögren's syndrome (pSS) is an autoimmune disease, which dominates the symptoms resulting from inflammatory infiltrates in exocrine glands. Frequently, pa‐ tients complain of a feeling of sand under the eyelids, eye irritation, and red eye caused by a decrease in tear secretion. The ophthalmic examination beyond lowering the secre‐ tion of tears in Schirmer's test evaluation in cases with a significant intensification of dry eye disease (DED) can be visualized by measuring ocular staining score (OSS) using lissa‐ mine green and fluorescein staining. OSS can demonstrate the degree of damage to the corneal surface. It is known that keratoconjunctivitis sicca (KCS) in pSS is not only limit‐ ed to the complaints of unpleasant feeling of sand under the eyelids but also can lead to serious corneal damage and decreased vision even to blindness. And between the others, complications of KCS in pSS must be replaced with an increased susceptibility to infec‐ tion. We should also pay attention to possible co-infection with Epstein-Barr virus (EBV) virus and bacterial co-infections, e.g., *Chlamydia pneumoniae, Staphylococcus aureus*, or la‐ tent conjunctival infections *Chlamydia trachomatis, Mycoplasma hominis*, and *Ureaplasma urealyticum* in group of patients with DED, not only in pSS group. Another issue is simul‐ taneous with hepatitis C virus (HCV) infection coexistance of clinical and laboratory fea‐ tures of Sjogrens syndrome and accompanying this situation clinical signs of KCS. To sum up symptoms of KCS in primary Sjögren's syndrome and in all patients with DED should be evaluated individually and should take into account the increased risk of infec‐ tion among these patients.

**Keywords:** dry eye, infection, Sjögren's syndrome
