Meenal Agarwal, OD - Beyond Dry Eye: Restoring Vision, Function & Quality of Life - D2
Dry eye in Sjögren's is far more than an irritation. It is an inflammatory breakdown of the tear film that can blur vision, trigger nerve pain, and quietly erode quality of life and mental health. Dr. Meenal Agarwal, a board-certified optometrist, explains how the eye's moisture system fails in Sjögren's and what can be done to restore comfort and function.
She breaks down the three layers of the tear film and the glands behind them, why up to 95 percent of adults with Sjögren's experience severe dry eye, and how chronic inflammation can damage the corneal nerves so that pain feels far worse than what an exam shows. She then walks through a full range of options, from artificial tears and warm compresses to prescription drops, light and heat treatments, and daily habits around screens, sleep, and nutrition.
What you will take away
Dry eye in Sjögren's comes from reduced tear quantity and quality across three layers (oil, water, and mucin), and an unstable tear film can cause fluctuating vision, halos, and glare, not just irritation
Pain that seems out of proportion to the exam can signal corneal nerve involvement, which is why some people still hurt despite using every drop
Core tools include non-preserved artificial tears, daily moist heat compresses, and inflammation-targeting drops such as cyclosporine and lifitegrast, with cyclosporine often taking up to six months to show benefit, so consistency matters
Daily habits support the tear film: the 20-20-20 screen rule, blink awareness, sleeping with the eyes fully closed, omega-3s in the triglyceride form, B vitamins, and good hydration
About Meenal Agarwal
Dr. Meenal Agarwal is a board-certified optometrist and a leading voice on the eye and brain connection, with a special clinical focus on dry eye disease, including complex and autoimmune-related cases such as Sjögren's. She owns three practices across the Greater Toronto Area, hosts the podcast Uncover Your Eyes, and is the upcoming author of Stuck in a Flat World (Fall 2026).
Not registered yet? If you want to join the conversation live, July 16 to 18, 2026, register for the free Virtual Sjögren's Summit: https://sjogrenssummit.com
Connect with Meenal Agarwal
Website: https://www.drmeenal.com
Instagram: / dr.meenalagarwal
LinkedIn: / dr-meenal-agarwal-od-9732a260
Chapters
0:00 Welcome
2:37 Dry eye out of proportion to the exam
5:09 Why Sjögren's eyes can also feel watery
7:39 Tear film quality and the optical surface
10:12 Corneal nerve pain
12:43 Living with severe dryness
15:16 Artificial tears and mild dry eye
17:50 Anti-inflammatory drops: cyclosporine and lifitegrast
22:54 Systemic management
25:25 Lid care and sleeping with eyes closed
27:58 Supplements: omega-3s and B vitamins
30:29 Focusing on daily function
This session is educational and does not take the place of individual medical advice. Please bring what resonates to the care team who helps you manage your health.