In a person who already has a form of arthritis, the sensation of dry eyes and mouth are usually enough to prompt testing for Sjögren’s. However, other diseases and conditions can cause these feelings, particularly in the mouth, and must be ruled out.

To begin the diagnostic process, your doctor will ask questions about the length of symptom duration – dry, gritty eyes or dry mouth and swollen salivary glands lasting more than three months are a sign of Sjögren’s.

Next come physical tests. The Schirmer test measures tear production to determine if your eye creates enough tears to keep it moist. The doctor places a paper strip inside each lower eyelid for five minutes (both eyes are tested at the same time) and the eyes are closed. When time is up, the amount of moisture is measured – 10 mm is considered normal

The slit-lamp exam allows your doctor to check the surface of the eye (cornea) for dryness-related damage. He’ll administer a dye to stain the tear film, most likely via eye drops, and he may dilate your eyes as well. Then he’ll view it through the slit lamp – a microscope with a high-intensity light source.

Oral tests include measuring saliva output, which is accomplished by weighing a dry sponge, inserting it under the tongue and weighing it again to determine how much saliva it absorbed. Salivary scintigraphy, a nuclear imaging test, can assess function of the salivary glands, as can sialography, an X-ray of the salivary glands (because Sjögren’s can affect the lungs, your doctor may order a chest X-ray to check for inflammation). A salivary gland biopsy can be used to collect tissue samples to check for inflammation.

Your doctor may also order bloodwork to check for autoantibodies – certain immune proteins that mistakenly target and damage organs or tissues. Among these are anti-nuclear antibodies (ANAs), Rheumatoid Factor, anti-Ro (SS-A) and anti-La (SS-B).

Your doctor may also test for immunoglobulins, other proteins that participate in ummune reactions and are usually elevated in Sjögren’s patients. And he may measure your Erythrocyte Sedimentation Rate (ESR), the rate at which red blood cells fall to the bottom of a test tube – also an indication of inflammation.

Once all the information is collected, your doctor will determine how many of each criteria you have, and decide if it adds up to a Sjögren’s diagnoses.

Sjögren’s Outlook and Treatment

Although it's frightening to think Sjögren’s can extend beyond the eyes and mouth to many parts of the body, it's important to realize that Sjögren's-related problems can be controlled, if detected early and treated properly, says Robert I. Fox, MD, a leading Sjögren's expert and practicing rheumatologist at Scripps Memorial Hospital in La Jolla, Calif.