Dry Mouth and Dry Eyes

Most people experience dry mouth or dry eyes at some point in their lives. However, if both dry mouth and dry eyes occur concurrently and/or chronically, a visit with a physician is in order. A proper diagnosis and treatment plan (if needed) will help prevent complications from dry mouth and dry eyes.

When the mouth is dry, people often say they have "cotton mouth." Dry mouth is not only irritating and painful, it also causes difficulty in swallowing due to the lack of moisture in the mouth. Speech and taste can be affected also. If not treated, chronic dryness of the mouth can cause tooth decay, tooth loss, and malnutrition.

Dry eyes often feel gritty and painful. When the eyes do not have sufficient moisture, it may feel like a foreign object is caught under the eyelid. If chronic dry eyes are not managed, infection and permanent damage to the eyes may result.

There are many causes of dry mouth and/or dry eyes. However, if the two symptoms are concurrent, Sjogren's syndrome, Limited Scleroderma, Ramsay Hunt syndrome, or certain medications may be to blame.

Sjogren's syndrome is an autoimmune disease that affects both the salivary glands and the tear ducts. In Sjogren's syndrome, the body's immune system is falsely alarmed and attacks the salivary glands and the tear ducts. Dry mouth occurs because the salivary glands are not producing saliva, and the eyes become dry due to little-to-no moisture production from the tear ducts. Symptoms of Sjogren's are primarily dry mouth and dry eyes. Sjogren's syndrome is sometimes comorbid with other autoimmune diseases such as Rheumatoid or Psoriatic Arthritis and Lupus. As with some other autoimmune diseases, Sjorgren's syndrome can go into remission (no symptoms are active). Some people with the condition experience many remissions throughout their lifetime while others only have a few periods of remission or none at all.

Limited scleroderma, or CREST syndrome, is also an autoimmune disease. Scleroderma literally means "hardened skin." Limited Scleroderma has many symptoms, but if the face and neck and/or digestive tract are affected, dry mouth and dry eyes can result.

Ramsay Hunt syndrome is a form of Shingles that develops near one of the ears. Its primary symptoms are a red rash with fluid-filled blisters near the ear and one-sided facial paralysis. Dry mouth and dry eyes can sometimes accompany the painful sores on the face.

Certain medications can also cause dry mouth and dry eyes. Patients should ask their doctor if the medicine they are taking can cause these symptoms.

The first step in diagnosing the cause of dry mouth and dry eyes should be a visit with a primary care physician. Discussion of symptoms, physical examination, and bloodwork are crucial in obtaining a proper diagnosis. A referral to a rheumatologist and/or ophthalmologist may be recommended for further testing. Biopsies from the inner lower lip and various eye tests can be performed to provide an accurate diagnosis.

Dry mouth can be eased with over-the-counter products that simulate saliva, and dry eyes may be relieved with over-the-counter artificial tears. It also can be helpful to use a humidifier to provide moisture in the air. If these remedies are not satisfactory, a doctor can prescribe medications to help manage the symptoms of dry mouth and dry eyes.