Lupus is an autoimmune disease. Your immune system is your body’s defense against foreign invaders, like germs. When you have an autoimmune disease, your immune system mistakes normal parts of your body as foreign and attacks them. The attack takes the form of inflammation. With lupus, the inflammation can affect any part of your body, including your eyes. Other autoimmune diseases can also affect the eyes. They include rheumatoid arthritis (RA), multiple sclerosis (MS) and diabetes. Autoimmune eye symptoms can include dry eyes, red eyes, decreased vision, and even loss of vision. The eye problems can result from the disease and from the medications you use to treat it. The Skin Around Your Eyes Skin is one of the most common areas that lupus attacks. Lupus can cause an itchy and scaly rash around your eyes and on your eyelids. This type of rash is discoid lupus. You could lose your eyelashes. You might get scar tissue along the edges of your eyelids. Eye symptoms include burning and itching. Sjogren’s Syndrome Sjogren’s syndrome is a common autoimmune condition seen with both lupus and RA. About 20% of people with lupus also have Sjogren’s syndrome. Dry eyes are the main symptom of Sjogren’s. Autoimmune inflammation of the tear glands causes this. Tear glands in people with Sjogren’s do not produce enough tears to keep the eyes moist and healthy. The eyes can become very dry, gritty, watery and itchy. Without treatment, the front surface of your eye can become scarred, and this can affect your vision. Artificial tears can prevent dryness and damage. Scleritis Your sclera is the white part of your eye. Scleritis is inflammation of the sclera. It affects about 1% of people with lupus. It occurs more often in people with RA. If you have scleritis, you may have pain. The outer, white part of your eye can become red. Sometimes the sclera can have a yellow color. In some people, scleritis is the first sign of lupus. Vasculitis of the Retina Inflammation of blood vessels is called vasculitis. Lupus inflammation often attacks blood vessels in the retina. That's the structure in the back of your eye where nerve cells receive light and send images to your brain to create vision. If the blood vessels that supply your retina become inflamed, you can lose parts of your vision. In fact, vasculitis of the retina is the most common eye problem in lupus. It affects up to 1 of every 4 people with lupus. Eye Nerve Problems If lupus attacks the nerves that control eye movements, it can cause double vision, weak eye movements, or droopy eye lids. Lupus may also attack the optic nerve. That's the main nerve that carries images back and forth between your eyes and your brain. Inflammation of the optic nerve can cause gradual or sudden loss of vision. MS is another autoimmune disease that causes inflammation of the optic nerve. Lupus Medications Lupus drugs that suppress your immune system can increase your risk of eye infections. Also, doctors sometimes treat lupus with drugs for malaria—called antimalarials. These drugs may also damage your retina. In addition, strong anti-inflammatory drugs—called steroids—are commonly used to treat a flare-up of lupus. Steroids can cause glaucoma (pressure in your eye) or cataracts (clouding of the lens of your eye). Your treatment plan for lupus will help control most of these problems. An ophthalmologist needs to be part of your overall care plan. This is a doctor who treats eye conditions and diseases with both medication and surgery. Your ophthalmologist will do periodic checkups and treat the symptoms affecting your eyes, which will help protect your vision.