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: Efficacy of Pulsed Light Therapy for Meibomian Gland Dysfunction and Dry Eye Syndrome

Eligibility criteria:
Inclusion Criteria:

          -  Age greater or equal to 18 y/o

          -  Patients presenting to academic referral center for DES

          -  Diagnosis of mild to moderate DES with meibomian gland dysfunction and ocular rosacea,
             based on evaluation of meibomian glands (MG), MG secretions, and other factors

          -  Facial rosacea

          -  Patients must not have started any new medications within the past 1 month

          -  Patients should not be using warm compresses or lid scrubs more than 1-2 times in the
             previous 2 weeks

          -  Symptomatic changes in DES

        Exclusion Criteria:

          -  Age < 18

          -  History of inflammatory DES (e.g. Sjogren's, rheumatoid arthritis, Stevens-Johnson
             syndrome, ocular cicatricial pemphigoid)

          -  History of trauma-induced ocular surface disease (thermal burns, chemical burns)

          -  Severe DES

          -  Pregnant women

          -  H/o seizures

          -  Significant unprotected sun exposure or use of tanning beds or creams in treated area
             (must be discontinued at least 2 weeks prior to treatment, during treatment course,
             and 2 weeks after last treatment)

          -  Use of Accutane, anti-coagulants, or St. John's Wort

          -  Active infections/immunosuppression

          -  Herpes 1 or 2 within the treatment area

          -  Patients who have undergone LASIK surgery within the past 12 months
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.


Eligibility (NLI label): Contradiction