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: Effects of Sustained Reading on the Ocular Surface

Eligibility criteria:
General inclusion criteria for all subjects will include:

          -  Ages 50 to 89 years

          -  Capacity to give informed consent.

          -  Self-reported literacy (i.e. a "Yes" answer to the question "Have you learned how to
             read?")

        Additional inclusion criteria for the dry eye group will include both of the below:

          -  A previous diagnosis of dry eye syndrome by an eyecare specialist

          -  Ocular Surface Disease Index total scoring of 13 or above

        Additional inclusion criteria for the Sjögren's syndrome group will include:

        - A previous diagnosis of Sjögren's syndrome by an immunology specialist, per ACR criteria
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        Additional inclusion criteria for normal control subjects will include:

          -  No previous history of dry eye diagnosis

          -  Ocular Surface Disease Index total scoring of 12 or under

          -  Total corneal and conjunctival staining score of 0

        Exclusion criteria will include:

          -  A binocular vision below 20/25 (with habitual correction)

          -  Any ocular surgery within the last 3 months.

          -  Mental issues, illiteracy, or language problems which might possibly interfere with
             reading ability

          -  History of taking or current use of topical prescription anti-inflammatory eyedrops
             (including, cyclosporine and steroids as well as any glaucoma eyedrops). Subjects who
             are willing to discontinue their treatment for at least a period of 30 days can be
             placed on a "wash out period" as per the discretion of the investigator and subject
             safety, and be eligible at the end of this period, given all other criteria have been
             met. Otherwise, subjects on these medications will be excluded.
No condition on gender to be admitted to the trial.
Accepts Healthy Volunteers
Subject must be at least 50 Years old.
Subject must be at most 89 Years

Eligibility (NLI label): Contradiction