TCM diagnosis Based on Syndrome Differentiation:
1. Tear break-up time and Schirmer tests
Tear break-up time and Schirmer tests are usually carried out by an ophthalmologist (a doctor who specialises in treating eye conditions). The tear break-up time test measures how effective your tear glands are. A non-toxic dye is dropped onto the surface of your eye and the colour of the dye allows the ophthalmologist to see how well your tear film is functioning and how long it takes for your tears to evaporate.

This test is also carried out using a slit lamp. A slit lamp is a low-power microscope with a high-intensity light source that can be focused to shine in a narrow beam. The specialist will use the slit lamp to examine your tear glands more closely. In the Schirmer test, small strips of blotting paper are placed into your lower eyelid. After five minutes, the strips are removed to see how much of the paper is soaked with tears.

2. Lip biopsy
During a lip biopsy, a small tissue sample is removed from your inner lip and examined under a microscope. A local anaesthetic is injected into the inner surface of your lower lip to numb the area, before a small cut is made to remove a few of your minor salivary glands. Clusters of lymphocytes (a type of white blood cell) in the tissue can indicate Sjogren's syndrome.

3. Blood tests
Blood tests are carried out to look for antibodies known as anti-Ro and anti-La (or SS-A and SS-B), which are produced when the immune system has been affected by Sjogren's syndrome. These antibodies are only present in about 60% of people with Sj?gren’s syndrome, so it's possible to have a negative blood test result and still have the condition.

4. Salivary flow rate
A salivary flow rate test measures how much saliva your glands produce. You'll usually be asked to spit as much saliva as you can into a cup over a five-minute period. The amount of saliva is then weighed or measured. An unusually low flow rate can indicate Sj?gren's syndrome.