Is Meibomian Gland Dysfunction Linked to Autoimmune Diseases?

Is dry eye syndrome related to autoimmune diseases?

The symptoms of dry eye syndrome have persisted for more than a year, and recently, the symptoms of dry mouth have become increasingly noticeable.
I went to the hospital for an examination, and the only abnormal result was an ANA titer of 1:80, while all other tests were normal.
The doctor said there was not much to worry about but prescribed Restasis for me.
After returning to the ophthalmology department for further examination, it was found that I have meibomian gland dysfunction.
Do I still need to follow up with a rheumatologist for further evaluation? If it is unrelated to autoimmune issues, can I stop taking the medication?

Ms. Huang, 40~49 year old female. Ask Date: 2024/06/18

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your inquiry.
You may want to collaborate with an ophthalmologist to see if treatment for your eyes improves your symptoms of dry mouth and dry tongue; if so, you might be able to discontinue the medication.
The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, is concerned about your well-being.

Reply Date: 2024/06/18

More Info

Meibomian Gland Dysfunction (MGD) is a condition that affects the oil-producing glands in the eyelids, leading to dry eye symptoms. The link between MGD and autoimmune diseases is an area of ongoing research. Autoimmune diseases, such as Sjögren's syndrome, rheumatoid arthritis, and lupus, can indeed contribute to dry eye symptoms and may also affect the function of the Meibomian glands. Sjögren's syndrome, in particular, is characterized by dry eyes and dry mouth due to the immune system attacking the glands that produce moisture.

In your case, you have been experiencing dry eye symptoms for over a year, along with increasing symptoms of dry mouth. The presence of a positive antinuclear antibody (ANA) test at a titer of 1:80 may suggest some underlying autoimmune activity, but it is important to note that a positive ANA test alone is not diagnostic of an autoimmune disease. Many healthy individuals can have a positive ANA without any associated disease. The interpretation of this result should be done in conjunction with clinical symptoms and other laboratory findings.

Given that your eye examination revealed MGD and you were prescribed medications like cyclosporine (Restasis) to help with your dry eyes, it is essential to continue monitoring your symptoms. While the eye doctor has indicated that your condition is primarily related to MGD, the worsening symptoms of dry mouth could warrant further investigation. Dry mouth, or xerostomia, can be a sign of Sjögren's syndrome or other autoimmune conditions, especially when it occurs alongside dry eyes.

Whether or not you need to see a rheumatologist or an immunologist depends on several factors. If your dry mouth symptoms persist or worsen, or if you develop other systemic symptoms (such as joint pain, fatigue, or skin rashes), it would be prudent to consult with a specialist. They can perform a more comprehensive evaluation, including additional blood tests and possibly a salivary gland biopsy, to assess for Sjögren's syndrome or other autoimmune conditions.

As for your current medication, it is crucial to follow your doctor's advice. If your symptoms improve with the prescribed treatment, it may be beneficial to continue using the medication. However, if you feel that your symptoms are solely due to MGD and not related to an autoimmune process, you should discuss this with your healthcare provider. They can help you weigh the benefits of continuing treatment against any potential side effects.

In summary, while MGD can be associated with autoimmune diseases, your specific situation requires careful evaluation. It is advisable to maintain open communication with your healthcare providers, including your ophthalmologist and potentially a rheumatologist, to ensure that all aspects of your health are being monitored and managed appropriately. Regular follow-ups will help in tracking any changes in your symptoms and determining the best course of action moving forward.

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