Does Rheumatoid Arthritis Affect the Eyes?


Most Common Eye Problems With RA

Uveitis

The uvea is the layer of blood vessels that sits between the retina and the sclera, and when RA inflames this part of the eye, you will notice pain and redness, along with blurry vision and sensitivity to light. Unlike other eye issues, serious, chronic uveitis tends to affect those with juvenile RA more often.

Left untreated, uveitis can cause scarring, and lead to permanent vision loss. Treatment typically begins with a corticosteroid eye drop, and if that doesn’t clear up the problem, your doctor may need to inject a corticosteroid directly into your eye.

Retinal Vascular Occlusion

This condition involves a blockage or interference in the blood vessels that feed the eyes, cutting off blood flow to the light-sensing part of your eye. Vision changes are more common than pain when retinal vascular occlusion is the problem: gradual darkening of your vision, or momentary blindness that comes and goes can signal a blockage in an artery.

The degree of permanent damage depends largely on what type of blood vessels has been blocked. If an artery is affected, your vision loss is more likely to be permanent; if the blockage occurs in a vein, laser surgery has been shown to help reverse the damage to your vision.

Glaucoma

When RA affects the optic nerve, pressure can build up inside the eye, and that is bound to affect your vision. That pressure increase within the eye can lead to glaucoma, a condition that normally brings pain, blank spots in your field of vision, and a rainbow effect around lights.

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Inflammatory arthritis leads to glaucoma, but so can treatment for inflammatory arthritis. Corticosteroid use can sometimes lead to pressure within the eye (as well as other eye problems), so be sure to mention any eye issues to your doctor and optometrist right away if steroids are a part of your RA treatment plan.

Cataracts

Cataracts is a condition where the lens of your eye becomes cloudy, leading to blurry vision, colors that seem dull and poor night vision. Changes often happen gradually, so a slight blur becomes a more pronounced problem as the old, damaged cells are compacted under new cell growth on the outside of the lens.

Cataracts are not necessarily painful, but they are problematic. Since the inflammation causes permanent damage to the lens of the eye, the clouded lens must be surgically replaced with an artificial one to restore clear vision.

When to Call the Doctor

Persistently dry eyes may seem like nothing to worry about, but remember a small change in the appearance or sensation of your eyes can be an early warning sign of a much bigger problem. Never wait to see if your irritation or vision changes will clear up on their own: the sooner you can get a diagnosis, the much more likely you’ll avoid permanent damage.

Since certain arthritis medications can increase your chances of developing eye issues (such as prednisone and plaquenil), it’s crucial that you visit your ophthalmologist regularly. Schedule an appointment every six months to make sure no changes in your retina, cornea, or sclera go undetected for too long.

Resources

Mayo Clinic (Can rheumatoid arthritis affect the eyes?)

Everyday Health (Eye Complications of Rheumatoid Arthritis)

HealthCentral (Rheumatoid Arthritis and Eye Health: Complications to Watch Out For)

Arthritis.org (6 Ways Arthritis Can Affect Your Eyes)

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