Medical Conditions Linked to Dry Eye Disease

A few systemic conditions that increase risk of dry eye disease and manifestations of other

ocular conditions.

- Sjogrens syndrome

o Pathophysiology

 Lymphocytic infiltration to exocrine glands including lacrimal and salivary

glands.

o Ocular Manifestations

 Filamentary Keratitis

 Corneal ulceration or scarring secondary to severe dry eye

- Rheumatoid arthritis

o Pathophysiology

 Systemic inflammation of synovial joints, may also affect uvea, sclera, and

cornea

o Ocular manifestations

 Scleritis

 Scleromalacia perforans

 Episcleritis

 Uveitis

 Peripheral Ulcerative Keratitis

- Systemic lupus erythematosus

o Pathophysiology

 Inflammation triggered by abnormal immune system activation

o Ocular manifestations

 Scleritis

 Episcleritis

 Uveitis

 Optic Neuritis

 Retinal Vasculitis

 Lupus Retinopathy

 Ischemic Optic Neuropathy

 Choroidopathy

- Granulomatosis with polyangiitis (GPA)

o Etiology

 ANCA-associated vasculitis

o Pathophysiology

 Necrotizing granulomatous inflammation of small to medium sized

vessels

o Ocular manifestations

 Scleritis

 Episcleritis

 Uveitis

 Orbital Pseudotumor

 Retinal Vasculitis

 Optic Neuropathy

 Ischemic Cranial Neuropathies

 Nasolacrimal duct obstruction

- Polyarteritis nodosa

o Pathophysiology

 Necrotizing granulomatous inflammation of medium-sized vessels

o Ocular manifestations

 Scleritis

 Episcleritis

 Optic Neuropathy

 Retinal Artery Occlusion

 Retinal Vein Occlusion

- Systemic sclerosis

o Pathophysiology

 Multisystem fibrosis, excessive collagen deposition

o Ocular Manifestations

 Dry eye disease secondary to fibrosis of lacrimal glands

 Blepharophimosis - eyelid tightening also secondary to fibrosis

 Decreased blinking

 Lagophthalmos

- Primary biliary cirrhosis

o Pathophysiology

 Cholestasis: reduced bile flow, increasing concentration of bile in liver

and bloodstream

o Ocular Manifestations

 Xanthelasma

 Ocular Pruitus

 Nyctalopia

 Advanced liver disease - vitamin A deficiency

• Compiled by Midwestern Intern c/o 2026 Miriam Freeman