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: Randomised Research Comparing Acupuncture, Herbal Treatment and Artificial Tear Eye Drops in Dry Eye

Eligibility criteria:
Inclusion Criteria:

          1. Age: 40-85 years, visual acuity better than logMAR of 1.0

          2. Chief complaint should be dry eye

          3. Symptoms:

             3.1. SPEED score > 6

             3.2. TCM score satisfies lung-kidney yin deficiency profile

          4. Signs:

        4.1. TBUT (<10s) or Schirmer's test (<10mm/5 mins) 4.2 Any corneal fluorescein staining

        Exclusion Criteria:

          1. Glaucoma or other ophthalmic disease, eg. Extraocular muscle palsies, ectropion,
             entropion

          2. Ocular allergies, eg. Allergic conjunctivitis, sinusitis, eczema, atopic
             keratoconjuntivitis

          3. Known of thyroid disorders (diagnosed by physician)

          4. Trichiasis

          5. Eye surgeries patients including LASIK (within 1 year)

          6. Steven-Johnson syndrome

          7. Sjogren's syndrome

          8. Eye related trauma (within 1 year)

          9. Contact lens wear (within 1 year)

         10. Punctal occlusion

         11. Systemic disease requiring regular medication (except hypertension and lipidemia)

         12. Pregnancy or planning to be pregnant

         13. Requirement for medications such as anti-microbial, inflammatory, creams (except
             moisturizers or cosmetics), or steroidal therapies

         14. Unable to do this clinical trial for any reason
No condition on gender to be admitted to the trial.
Accepts Healthy Volunteers
Subject must be at least 40 Years old.
Subject must be at most 85 Years

Eligibility (NLI label): Contradiction