*4.2. Ocular Manifestations*

Dry eye is a classic manifestation of pSS, part of the sicca syndrome affecting more than 95% of pSS patients. Patients can report inability to tear, foreign-body sensation, conjunctival inflammation, eye fatigue and decreased visual acuity. Ocular dryness can be complicated by keratoconjunctivitis sicca, blepharitis, bacterial keratitis or corneal ulcer [206]. Uveitis, episcleritis and orbital pseudotumor are rare but possible systemic manifestations [207].
