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Patients with arthritis can develop eye conditions. This article outline 6 different eye conditions that can affect patients with arthritis.

Arthritis is, of course, best known for its joint pain, swelling and stiffness — but this condition can also affect other parts of the body, including the eyes. This is attributed to the chronic inflammation seen in patients with arthritis.

Rheumatoid arthritis is an autoimmune disease (in which the body’s immune system starts to attack healthy tissue) that is characterized by deterioration of collagen in the joints. The eyes are made up of the sclera (the white of the eye) and the cornea (the lens cap), which also contain collagen. Thus, the immune system of someone with rheumatoid arthritis not only attacks collagen of the joints, but also of the eyes.

These are the six eye conditions that can develop in patients with arthritis.

1. Keratitis sicca (dry eye syndrome)

Keratitis sicca is a disease in which the eye can no longer maintain a healthy layer of tears. This layer or film helps lubricate the eye and protect the eye from foreign pathogens. Thus, it is necessary for maintaining properly hydrated eyes and important for good vision. This disease can lead to infection of the eye and corneal scarring. Patients who develop keratitis sicca may notice:

  • Dryness of the eye
  • Feeling of having something in the eye
  • Blurred vision
  • Specks on your eye, like having a dirty windshield

Keratitis sicca is commonly seen in patients with rheumatoid arthritis. In fact, it is the most common disease of the eye in patients with rheumatoid arthritis, and women are nine times more commonly affected than men. Treatments for keratitis sicca are:

  • Anti-inflammatory medication prescribed for arthritis
  • Topical salve
  • Artificial tears
  • Immunosuppressive eye drops (cyclosporine) which helps keeps your eyes moist
  • Tear duct plugs
  • Using a humidifier in the bedroom
  • Switch medications (if dryness is caused by a medication you are taking)

2. Scleritis

Scleritis is a disease that is characterized by inflammation of the sclera (the eye wall) or the white part of the eye (cornea). This causes either the sclera or the cornea to become thin, which is not good because when the components of the eye are too thin, that can cause even a minor trauma to split a part of the eyeball open. This tends to mostly affect patients with autoimmune arthritis such as rheumatoid arthritis. This is what patients will notice:

  • Redness that won’t go away, despite using medication
  • Severe pain
  • Sensitivity to light
  • Reduced vision

These are some of the treatments for scleritis:

  • Corticosteroid eye drops (to control inflammation)
  • Continue to take your arthritis medication to keep inflammation under control

3. Uveitis

Uveitis refers to the Inflammation of the uvea (the layer of the eye that has the blood vessels), which resides between the retina and the sclera. Uveitis largely affects patients with with juvenile arthritis, ankylosing spondylitis, psoriatic arthritis and reactive arthritis. These are the things that patients may notice:

  • Pain
  • Redness
  • Blurred vision
  • Sensitivity to light
  • In extreme cases, vision loss

These are some of the treatments for uveitis:

  • Arthritis medication to control inflammation
  • Corticosteroid eye drops
  • Oral corticosteroids
  • Corticosteroid injections
  • In some cases, antibiotics

4. Retinal vascular occlusion

Retinal vascular occlusion is a disease in which small blood vessels that provide oxygen to the retina (light sensing layer of the eye) become blocked. This can affect patients with lupus. This is what you may notice:

  • Vision loss, which may come and go, suddenly occur or be gradual
  • Curtain coming over the eye

Currently, there is no way to restore vision. However, if a vein is blocked, then laser surgery can help reduce swelling and restore vision.

5. Glaucoma

Glaucoma is a type of disease that results in damage to the optic nerve, leading to vision loss. This is usually due to high blood pressure inside the eye. Glaucoma causes inflammation of a valve in the eyes that helps maintain pressure within the eye. Thus, inflammation of the valve can disturb eye pressure and cause glaucoma. This affects patients with ankylosing spondylitis, psoriatic arthritis and inflammatory arthritis. These are the things patients may notice:

  • Eye pain
  • Vision that is blurry
  • Blank spots in the vision
  • Rainbow-colored halos around light

It is important to get regular eye exams so that if it develops, the doctor can start the treatment early. Treatments for patients with glaucoma involves the use of either one or a combination of different eye drops that reduce pressure in the eye. In case these are successful, then patients may undergo surgery to lower the pressure. For patients with arthritis, it is important to prevent glaucoma by lowering corticosteroid use, as that is associated with higher pressure of the eye.

6. Cataracts 

Cataracts are inflammation of the eyeball, and commonly affect patients with inflammatory diseases such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. Patients may notice:

  • Cloudy or blurry vision
  • Poor night vision
  • Faded colors

Treatment of cataracts normally involves surgery.

  • Lambert, J. R., and V. Wright. "Eye inflammation in psoriatic arthritis." Annals of the rheumatic diseases 35.4 (1976): 354-356.
  • Fujita, Miho, et al. "Correlation between dry eye and rheumatoid arthritis activity." American journal of ophthalmology 140.5 (2005): 808-813.
  • Lemp, Michael A. "Dry eye (keratoconjunctivitis sicca), rheumatoid arthritis, and Sjögren’s syndrome." American journal of ophthalmology 140.5 (2005): 898-899.
  • Photo courtesy of SteadyHealth

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