TOPLINE:

The prevalence of dry eye disease (DED) varied widely across patients with different autoimmune conditions, affecting more than 80% of patients with Sjögren disease and fewer than 25% of patients with Crohn’s disease. DED appeared about 3 years before autoimmune disease diagnosis and was likely to progress to other complications in certain conditions.

METHODOLOGY:

• Researchers analyzed data from a Taiwan-based database to assess the prevalence, timing, and severity of DED in patients with autoimmune diseases.
• They included 67,264 patients who were newly diagnosed with one of 10 autoimmune diseases between 2011 and 2020.
• Researchers measured the prevalence of DED, the interval between DED and autoimmune disease diagnosis, and rates of keratitis and corneal ulcer as indicators of more severe eye-surface damage.
• Patients were followed up using available health records up to 2021 to capture onset and complications.

TAKEAWAY:

• The prevalence of DED was highest in patients with Sjögren disease (81.3%) and lowest in those with Crohn’s disease (23%), with consistently higher rates in women across patients with all autoimmune conditions.
• DED usually appeared about 3 years before the autoimmune disease diagnosis, and patients with vs without DED were older at diagnosis (eg, Crohn’s disease, 53.57 vs 39.57 years; P < .001).
• Patients with Sjögren disease had the highest rates of keratitis and corneal ulcer (30.7% and 3.3%, respectively), with notable rates seen in patients with vasculitis (27.1% and 2.5%, respectively), systemic lupus erythematosus (23.8% and 2.9%, respectively), and rheumatoid arthritis (21.6% and 3.0%, respectively).
• The rate of progression from DED to keratitis and to corneal ulcer was highest among patients with vasculitis (27.6% and 10.6%, respectively).

IN PRACTICE:

“DED often preceded autoimmune disease diagnosis by approximately 3 years, suggesting that ocular surface involvement may represent an early systemic manifestation and provide an opportunity for earlier clinical evaluation, despite possible diagnostic delay,” the authors of the study wrote.

SOURCE:

The study was led by Nan-Ni Chen, MD, Chang Gung Memorial Hospital, Chiayi, Taiwan. It was published online on February 23, 2026, as a research letter in JAMA Network Open.

LIMITATIONS:

The study lacked detailed eye exams and data on severity of symptoms, biomarkers, and treatment. Severity defined by keratitis or corneal ulcer may have included non‑DED causes.

DISCLOSURES:

The study received funding from the Chang Gung Memorial Hospital, the National Science and Technology Council of Taiwan, and the Ministry of Science and Technology. The authors reported no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.