Ocular symptoms (at least one of the following symptoms):

Daily, persistent, troublesome dry eyes for more than three months

Recurrent sensation of sand or gravel in the eyes

Use of tear substitutes more than three times per day

Oral symptoms (at least one of the following symptoms):

Daily feeling of dry mouth for more than three months

Recurrent or persistently swollen salivary glands as an adult

Need to drink liquids frequently to aid in swallowing dry food

Ocular signs (positive results from at least one of the following tests):

Schirmer test

Rose bengal test or other ocular dye test

Histopathology (positive biopsy of a salivary gland)

Salivary gland involvement (positive results from at least one of the following tests):

Unstimulated whole salivary flow collection (less than 1.5 mL in 15 minutes)

Parotid sialography showing the presence of diffuse sialectasia

Salivary scintigraphy showing delayed uptake, reduced concentration, and delayed excretion of tracer

Presence of antibodies to anti-SS-A and anti-SS-B antigens