Sterile corneal ulcerations and perforations associated with Sjögren's syndrome affected 18 eyes in 14 patients. Seven of the 18 eyes were perforated on presentation. Nine of the 18 eyes had received topical steroid treatment prior to referral. Two of the eyes had undergone recent anterior segment surgery and suffered perforated corneas postoperatively while receiving topical steroid treatment. All 14 patients had successful management of their corneal ulceration or management of their corneal ulceration or perforation (reepithelialization of the corneal defect, restoration or maintenance of the anterior chamber, and stromal scarring with visual acuity equal to or better than on presentation). Two of the 18 eyes had sterile infiltrated ulcers. We believe that this type of ulcer responds less predictably to therapy than the noninfiltrated lesions.