Rheumatoid arthritis and eyes
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Scleritis, a chronic inflammation of the blood vessels in the eyes, occurs in about 1 percent of people with RA.
Symptoms include eye pain and redness. If it goes untreated, scleritis may become severe, leading to a deterioration of the cornea. Corneal ulcerations are rare but are serious.
Episcleritis is another type of inflammation which is not as severe but still requires attention and therapy. Episcleritis occurs occasionally and is manifested by mild pain and intense redness of the affected eye.
People with RA are also at increased risk for Sjögren's syndrome, classified in this case, as secondary Sjögren's syndrome.
Dry eyes are a key symptom of Sjögren's syndrome, a chronic condition that occurs when the body's immune system attacks moisture-producing glands, including the tear glands. Symptoms include a burning, gritty feeling. If not treated, dryness can lead to eye infections or even damage to the cornea.
Keratoconjunctivitis in Sjogren's syndrome is the most common ocular manifestation of rheumatoid arthritis. Sicca (dry eyes) is a common complaint.
Eye inflammation tends to occur in children with pauciarticular JRA. Signs and symptoms of eye inflammation can include red eyes, eye pain and increased pain when looking at light. Eye inflammation may not produce signs and symptoms in about half of children with pauciarticular JRA. Routine eye examinations are recommended because eye inflammation may result in blindness.
Finally, cataracts often occur in patients with rheumatoid arthritis treated with glucocorticoids (steroids). Long duration of treatment and higher doses are risk factors.
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