Eye care in the community Part 9 – Sjögren’s disease

Sjögren’s disease (or more accurately syndrome, as the condition can affect multiple sites throughout the body) does not always present as a variation on dry eye disease. Here are two cases involving symptoms of twitching, throbbing and shooting pains.

Case 1

An 85-year-old female rang to say she had been experiencing sharp ‘electric shocks’ on the right side of her face. She had been experiencing them sporadically on a daily basis for the past few days, and now they were happening at increasingly regular intervals. She was now very concerned and was afraid to touch her face.

Ocular examination
• Visual acuity:
• R: 6/18 due to previous episode of atypical optic neuritis some 20 years ago
• L: 6/7.5 with clear intraocular implant and no optic disc abnormality, except for peripheral laser photocoagulation following retinal detachment
• Intraocular pressures: R 17mmHg & L 16mmHg
• Right OCT scan shows no progression of loss of nerve fibres or ganglion cell loss (figure 1)