Dry Eyes and Sjogren’s Syndrome


Pathology: 

There are 2 distinct sub-types associated with dry eyes or what medically is called kerato-conjunctivitis sicca.

The first one may be described as age related producing generalised atrophy of the lacrimal and meibomian glands of the eyes and eyelids. This is part of the normal ageing process and relates to the diminution of tear production from the acini in our glands in our orbits. The glands literally do not produce enough tears and if one were to blame a particular organ system one would lean to suggesting a lack of hormones maintaining our eye health. You may ask what hormones control tear production and one would suggest serotonin, androgens, oestrogen and peptide hormones etc. These hormones turn on and turn off our tear production. In some components there is a similarity to dry mouth, although the hormones are different but the effect and mechanism of action on our salivary glands are similar. 

Another injury that may result in a perception of dry or gritty eyes occurs after LASIK or refraction surgery. The aetiology is a neuropathic injury to the nerves which are sensory to the conjunctiva and cornea, in this case the ophthalmic or first division of the Trigeminal nerve. This occurs from a neuropathic injury to the tiny nerve fibres relaying the sensory area of the outermost layer of the cornea. Why these nerve suffer an injury is only understood to the extent that a cut anywhere in the body is going to interrupt the nervous impulse and function of the neurone or nerve cell. The concept of stem cells is that stem cells are neurotrophic and encourage the growth and repair of nerve cells, thus limiting neuropathic injury. The perceived neuropathic injury caused by refraction surgery is caused by interrupting the nerve cells on the cornea. This leads to a perception of dry eyes even though this may not be confirmed by a Schirmers test (measures tear production).

The other sub-type is Sjogren’s syndrome, an autoimmune disorder which manifests in the triad of dry eyes, dry mouth and arthritis. Of course within this syndrome there may be mild, moderate or severe manifestations of the disease. Sjogren’s is generally seen more in females than males, 30-50 year old age group and can be quite debilitating. There is no known cure and the treatment is more symptomatic than curative. For instance if you have dry eyes  use eye drops, dry mouth then use a mouth wash,  etc. Sjogren’s is a progressive disease so as the lacrimal glands are progressively damaged by inflammatory disease then the production of tears is slowly turned off. One would suggest that early treatment is better than late treatment and is aimed at trying to replace the damaged serous and mucous cells in our lacrimal glands.

STEM CELLS FOR DRY EYES AND SJOGREN’S SYNDROME

The very nature of the aetiology of dry eyes dictates the appropriate treatment. For instance if the dry eyes is as a result of refractive or LASIK surgery we would recommend injection of stem cells close to the branches of the ophthalmic division of the Trigeminal nerve combined with hyperbaric oxygen (HBOT) to try to encourage new cells to repair the damaged nerves on the conjunctiva and cornea. 

Age related dry dry eyes is probably harder to get an effective solution and treatment plan since the whole underlying problem is one of lack of hormones encouraging the lacrimal glands to function. In this situation we would advocate The use of stem cells injected directly into the lacrimal glands has now been advocated by major groups and publications have demonstrated clear and encouraging results. Intravenous infusion of stem cells should also be considered although the use of IV stem cells is empirical and somewhat analogous to the use of IV stem cells in the anti-ageing process. Of course the use of combined hyperbaric therapy (HBOT) and stem cells is recommended to encourage the stem cells to differentiate better into lacrimal gland cells. The stem cells work best in an oxygen rich environment. 

SUMMARY

Dry eyes and Sjogren’s syndrome can be an irritating and debilitating side effect of ageing and autoimmune disorder. There are no easy surgical cures. The use of stem cells and hyperbaric therapy is a relatively low risk procedure that may or may not have results. Ideally for age related dry eyes and Sjogrens the earlier the stem cell treatment infusion and HBOT the better, multiple treatments may be required. Professor Vickers and his team are ready to assist.

At Eurostemcell.life we pride ourselves on ensuring patients know the team diagnosing and conducting their stem cell therapy. Professor Russell Vickers is the lead specialist, working within a team of specialist surgeons and doctors.

Important questions that patients should ask of any treating clinicians and facility:

  • Are my treating doctors specialist surgeons/doctors and stem cell experts?
  • How many publications and research based studies have they published in peer reviewed journals?
  • Can they augment stem cell therapy with the known benefits of adjunctive therapy?

Eurostemcell.life is Europes premier stem cell organisation guided by evidence based medicine and clinical research.

Our founding director, Professor Russell Vickers PhD, MDsc, M Med, MA, FFPM (ANZCA) is an Australian and New Zealand board registered surgeon with over 100 publications, books and thousands of invited lectures and presentations on stem cells, pain, peptide synthesis and biochemistry. Professor Vickers is the leader of a family team of surgeons assisting him including Dr Peter Vickers, MD, FRCS (Edinburgh), FRACDS, Dr Richard Vickers, MD, FRCS (England, Glasgow, Ireland), FRACDS (OMS) and Dr Jessica Vickers, MD, MCOM, BA/BN as co-ordinator.

This medical summary has been written by Professor Vickers and his family team of specialist consultants.

It has been written by medically qualified writers.

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