HMN 2026: How Dry eye often precedes autoimmune disease diagnosis,

Frequent dry eyes may signal more than simple irritation and could be an early warning sign of an autoimmune disease. This symptom has long been associated with Sjögren’s Disease, a chronic autoimmune condition in which the immune system mistakenly attacks the tear ducts and salivary glands, causing inflammation that leads to dry eyes and dry mouth. Now, a study of 67,264 patients in Taiwan with autoimmune diseases found that dry eye disease (DED) preceded the autoimmune diagnosis by about three years.

Predictably, in Sjögren’s Disease, the prevalence of diagnosis following the occurrence of DED exceeded 80%. Across nine other autoimmune conditions, rates consistently exceeded 20%, with rheumatoid arthritis ranking second highest at 39.3%, while Crohn’s disease recorded the lowest rate at 23.0%.

DED provides a vital window of opportunity for doctors to perform earlier clinical evaluations for underlying autoimmune issues and plan effective treatment plans to deal with the symptoms. The findings are published in JAMA Network Open.

Focusing on early detection signs

With every blink, tears spread across the eye’s surface, creating a thin layer that keeps vision clear. If the eyes don’t produce enough tears or the tear film becomes unstable, the surface dries out, leading to dry eyes. It is quite prevalent, affecting about one in 11 people worldwide, and in Taiwan, the numbers are between affecting 5–40% of adults over 40 in Taiwan.

Previous research did not include enough large, detailed data to clearly show how common DED is or what it looks like in people with different autoimmune conditions. Identifying patterns unique to each disease could help doctors detect it sooner and manage it more effectively.

In this study, the team collected patient data from Taiwan’s National Health Insurance Research Database between 2008 and 2021. They focused on 10 major autoimmune diseases identified using official registry codes and compared: the prevalence of common DED for each autoimmune disease, age at diagnosis, and progression to more severe eye problems.

Statistical analysis of the data revealed that the risk of developing dry eyes depends heavily on which autoimmune condition a person has. For instance, the DED in the case of Sjögren’s Disease was 81%, but in the case of lupus it was only 38.13%, and similarly, for systemic sclerosis, it was 34.62%. Also, individuals with DED were diagnosed with autoimmune diseases at an older age than those without DED.

The data highlighted a clear gender difference in the occurrence of DED, showing that women were more likely than men to develop dry eyes across all the diseases studied.

Apart from being an early indicator, DED associated with autoimmune conditions generally involves more severe inflammation and symptoms. If left untreated, it can lead to serious issues such as keratitis (inflammation of the cornea) and corneal ulcers. The researchers emphasize early recognition of DED and proactive care to treat it, to help reduce the risk of permanent vision damage.

Greater awareness of DED as a potential early warning sign could encourage more people to seek evaluation, leading to earlier detection of underlying autoimmune disease when present, and if not, proceed with a general DED treatment plan.

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