Results of dry eye tests and ocular symptoms were compared and correlated in patients with primary Sjögren's syndrome (1 degree SS), in patients with connective tissue disease differing from 1 degree SS, and in normal controls. Patients with 1 degree SS had many and pronounced ocular complaints, however, non-diagnostic for the disease. Break-up time and Schirmer-1 test results below 10 mm/5 min both had high sensitivity but low specificity, whereas the reverse was true for Rose-Bengal score and Schirmer-1 test below 5 mm/5 min. Presence of snake-like chromatin in conjunctival imprints and the lactotest on tear fluid did not qualify as alternative tests since they had very low specificity and were less sensitive than the Schirmer-1 test and break-up time. Cornea sensitivity was not found to be an appropriate test at all. In 21% of eyes the presence of keratoconjunctivitis sicca changed from one consultation to the next in patients with 1 degree SS. Examination for keratoconjunctivitis sicca should therefore be repeated in test negative cases where symptoms indicate 1 degree SS.