How Rheumatoid Arthritis Can Affect Your Eyes
Rheumatoid arthritis (RA) is an inflammatory disease characterized by swelling and irritation. The inflammation of RA occurs when your body's defense system (immune system) attacks your own body tissues instead of foreign invaders like viruses or bacteria. Most of these attacks occur in your joints, but RA inflammation can also affect other parts of your body.
Your eyes are especially vulnerable. Areas affected by RA inflammation include the lacrimal glands that moisten the eye, the white scleral coat that protects the eye, and the inside parts of the eye. If you have dry eyes, redness, pain, or loss of vision, you should see an ophthalmologist (an eye specialist) for a diagnosis and treatment. It may be directly related to your RA.
Dry Eye Syndrome
RA inflammation of the lacrimal glands that moisten your eyes can cause dry eye syndrome. This is the most common eye problem among people with RA, affecting about four in 10 patients. Symptoms may be worse in the evening, after eye strain, and when you're exposed to cold, dry air. Eye symptoms include:
A test called the Schirmer's test can be done to measure the amount of moisture in your eye. Treatment for dry eye includes using moisturizing drops or ointments and wearing protective sunglasses on dry, windy days. An eye drop medication called Restasis blocks inflammation in the eye and improves tear production.
Inflammation of the white outer part of your eye is called scleritis. It affects about one in 10 people with RA. Episcleritis is a more superficial form of scleritis and is less severe. Eye symptoms of scleritis include pain and redness.
An ophthalmologist can usually diagnose scleritis and episcleritis during an eye exam. Treatment may include eye drops or oral steroids. Modifying your current RA therapy may also relieve eye problems.
Inflammation of the richly-vascularized tissues inside your eye is called uveitis. Uveitis is the most common eye problem in children with RA. Parts of your eye that can be affected by uveitis include the iris and the choroid, the inside lining. Eye symptoms of uveitis include:
Dark spots in your vision
Sensitivity to light
An ophthalmologist may use a special instrument called a slit lamp to look inside the eye and diagnose uveitis. Treatment includes using drops to open the pupil of your eye. This reduces pain and prevents scarring. Wearing dark glasses will protect your eyes. Your doctor might prescribe steroid or other anti-inflammatory eyedrops or pills. Uveitis that lasts longer than three months can result in progressive vision loss. RA-related eye problems need aggressive treatment and close follow-up.
Work closely with the members of your medical team and follow their directions carefully, especially if you are taking steroids. Steroids can having negative side effects including cataracts, which is clouding of the normally clear lens of the eye, and glaucoma, which is increased pressure inside the eye.
RA may affect not only your joints but also other parts of your body such as your eyes.
RA inflammation can involve your tear ducts, the outside of your eye, or the inside of your eye.
If you have eye symptoms like dryness, redness, pain, or loss of vision, call your doctor right away.