Patient case (clinical description): A 40-year-old woman comes to the clinic complaining of gritty sensation in her eyes. She also has difficulty swallowing dry foods with no pain or heartburn.  The patient is a schoolteacher and must drink water frequently during lectures due to her mouth dryness.  She also reports occasional joint pain.  Medical history is not significant other than the confirmed Sjogren disease with no other rheumatologic disease.  She is sexually active with her husband and has 2 children both delivered by natural vaginal delivery. She has no history of any kind of surgery. Physical examination shows conjunctival erythema and cracking of the lips. The remainder of the examination and history is normal. Her lab result shows elevated ESR (50 mm/h)

Patient's own account: I went to the clinic because I had a terrible gritty sensation in my eyes. It was also hard to swallow dry food, but it didn't burn, and there was no pain. I'm a 40-year-old female school teacher and I should drink water for the lectures because otherwise, my mouth gets really dry. I also have joint pain from time to time. I have been diagnosed with Sjogren disease but no other rheumatologic disease. I have a husband, we're sexually active, and I also have two lovely children that I delivered both naturally. I never undergone any surgery. Physical examination when I came to the clinic, and it showed cracking on my lips and a pink eye. The rest was fine. I also did some lab tests, and they came back with high ESR.

Clinical trial: Acupuncture for Dry Eye Syndrome

Eligibility criteria:
Inclusion Criteria:

          -  Patients who have had dry eye syndromes in single eye or in both eyes e.g. Other
             disorders of lacrimal gland: Dry eye syndrome (ICD-10: H04.1). He or she must have
             both of the conditions below:

               1. Patients who have had such symptoms like ocular itching, ocular foreign body
                  sensation, ocular burning, ocular pain, ocular dryness, blurred vision, sensation
                  of photophobia, ocular redness, sensation of tearing

               2. Patient whose tear film break-up time (BUT) is below 10 seconds and measured tear
                  amount is below 10mm/5sec by Schirmer 1 test

        Exclusion Criteria:

          -  Those who have defects of eyelid or eyelashes

          -  Those who have acute infection of eyelid, eyeball or accessories of eye

          -  Those who have Stevens-Johnson syndromes or Pemphigoids

          -  Those who have Vitamin A deficiency

          -  Those who have any defects of eye or accessories of eye by external injuries

          -  Those who have undergone any surgical operation for eye during last 3 months

          -  Those who are using contact lens

          -  Those who have any difficulties about eye opening or eye closing due to facial palsy

          -  Those who have undergone punctual occlusion surgery

          -  Those who have used any kinds of anti-inflammatory eyedrops for recent 2 weeks
             (steroids, cyclosporin or autologous serum eyedrops)

          -  Those who have systemic immune therapy

          -  Those who are pregnant or have any plan for pregnancy

          -  Those who are not appropriate to this study by investigators decision
No condition on gender to be admitted to the trial.
No healthy subjects accepted to join the trial.
Subject must be at least 18 Years old.
Subject must be at most 65 Years

Eligibility (NLI label): Contradiction