How Does Rheumatoid Arthritis Affect the Eyes: A Complete Guide

Dec 23, 2023 By Madison Evans

Individuals with rheumatoid arthritis (RA), an inflammatory form of autoimmune disease where the body's immune system erroneously attacks the joints, are more likely to develop eye problems. Inflammation is brought on by these attacks, which results in painful joints that are also swollen and rigid.

Joint injury and impairment may develop as a result of chronic inflammation. Because RA is a systemic illness, the symptoms it causes can affect the entire body. Those with more severe diseases have symptoms affecting their entire body or system.

It may cause inflammation in other body regions, such as your skin, blood vessels, and eyes. Everything you need to know about rheumatoid arthritis's potential effects on your eyes and the kinds of eye issues you can encounter is outlined here.

The Effects Of Rheumatoid Arthritis On Eyes

A malfunction of the immune system brings on rheumatoid arthritis. The immune system's main job is to protect against and eliminate pathogens, which can either prevent illness or aid in its recovery. In rheumatoid arthritis illnesses, the immune system can attack healthy cells by mistake.

Symptoms of an immune system "attack" often include localized redness, discomfort, and swelling. RA attacks collagen, the primary protein in connective tissue. The cornea and sclera of the eye are primarily composed of collagen as well. In addition to the numerous other tissues in and around the eyes, their existence allows RA symptoms to manifest in the eyes.

People with RA report feeling dry more often than any other symptom. The immune system destroys the lacrimal and meibomian glands, which produce tears and oil to keep the eye moist. This results in secondary Sjogren's syndrome, associated with rheumatoid arthritis.

Yet, Sjogren's syndrome can happen by itself (primary). Ocular symptoms of RA include inflammation of the eyes. The immune system targets the collagen-rich tissues of the eye. Tissue irritation and inflammation may result from this.

Eye Problems Caused By Rheumatoid Arthritis

Glaucoma

Glaucoma is a disorder of the eye caused by a rise in the eye's internal pressure. Failure to address the problem can permanently damage the optic nerve and impaired or complete loss of eyesight. Glaucoma can be caused by increased pressure within the eye, which can be caused by rheumatoid arthritis.

Moreover, corticosteroid treatment for arthritis has been linked to an increased risk of developing glaucoma. It is possible for people who have the beginning stages of glaucoma not to experience any symptoms; consequently, it is very important to have routine eye exams at an eye clinic so that they can test for glaucoma.

It should be done even more frequently if you have rheumatoid arthritis. If detected early, glaucoma can be controlled with eye drops topically applied to the affected eye; nevertheless, surgery may be necessary in some cases.

Dry Eye Disease

Dry eye disease, often known as Keratoconjunctivitis sicca, is a frequent ocular problem associated with RA. Insufficient or absent tear production is the cause of this condition. There are several potential reasons for dry eyes, but rheumatoid arthritis and Sjogren's disease are among the most frequent. Symptoms of dry eye disease can range from quite minor to severely debilitating. Some of the symptoms are:

  • Blurred vision
  • Dry eyes
  • Redness
  • A feeling of grittiness in the eyes
  • Eye irritation

Dry eye syndrome must be treated to prevent infection or damage to the cornea. Effective therapy for dry eye syndrome is available, with options based on the condition's etiology, symptoms, and severity. While over-the-counter eye drops can help with mild instances, prescription eye drops, anti-inflammatory drugs or even surgery may be necessary for more severe cases.

Sclera

The sclera, or white of the eye, functions as the eyeball's lining. They help maintain the eyeball's shape while shielding the organs housed there. The sclera comprises interwoven tissues like a web, and RA can attack them. Scleritis is the medical term for inflammation of these tissues.

Anterior scleritis affects the front of the sclera, whereas posterior scleritis affects the back (posterior scleritis). The sclera can be affected by rheumatoid arthritis in many ways. One of the most typical manifestations of scleritis is inflammation of the scleral surface.

Raised nodules on the sclera are also possible, as is the erosion of scleral tissue; however, both conditions are far less common. Most people with scleritis report the following symptoms:

  • Excessive tearing
  • Severe eye pain
  • Redness
  • Blurred vision
  • Swelling
  • Light sensitivity

Uveitis

Inflammation of the uvea, the tissue layer in the back of the eye, is called uveitis (uvea). Blurred vision, discomfort, and redness in the eyes are the results. One or both eyes may be affected. Up to 42% of RA patients with ocular involvement have uveitis.

Etanercept is a TNF blocker used to treat RA, and there is evidence that it may be linked to an increased risk of uveitis in this population. Uveitis is a potentially blinding disease. The best chance of avoiding problems and keeping one's eyesight intact relies on prompt diagnosis and treatment. Signs and symptoms are the following:

  • Eye pain
  • Blurry vision
  • Sensitivity to light
  • Decreased vision
  • Eye redness
  • Floating dots in eyesight are termed floaters

Cataracts

While cataracts are typically associated with aging, they can appear anytime in patients with rheumatoid arthritis. Inflammation of the eye can cause the normal crystalline lens to change from clear to hazy, which is why this occurs.

The surgical removal of cataracts is a simple procedure in almost all cases. It is accomplished by replacing the eye's natural hazy lens with an implant that will not degrade with time. Cataract surgery can be performed on patients of any age when medically required.

Conclusion:

People with inflammatory arthritis need to see an eye doctor often for preventative treatment. And report any changes or concerns about their vision to their rheumatologist or ophthalmologist, no matter how trivial they appear.

Checking for damage to the eyes at the earliest possible stage is why annual dilated eye exams at the eye doctor are so crucial. Because certain eye disorders, especially in their early stages, may not produce significant pain or noticeable vision changes, it is crucial to get regular eye exams.

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