At the follow-up, the patient reported no problem with the use of LACRISERT® (hydroxypropyl cellulose ophthalmic insert). I instructed her to continue with the therapy, along with the other aspects of her regimen. Additionally, I introduced and discussed advanced dry eye treatments with the patient, telling her that we were holding them in reserve for use should her condition warrant. These include autologous serum drops and amniotic membrane placement.
Many patients with Sjögren’s syndrome will have to consider such advanced therapies as their ocular condition progresses. Because initiating these types of treatments can be a particular challenge in this patient population, I find it extremely helpful to introduce potential follow-on therapies at an early point. Regardless of efficacy, each of these therapies has its own challenges. An amniotic membrane placement will blur vision for a while; autologous serum will require the patient to be vigilant about its storage. Having an early discussion makes patients aware of their options and prepares them to incorporate such treatments if and when the time comes.