Dr Sangita Wagh

Patients of arthritis often have problems related to their eyes. These problems stem from the fact that the tissues of the eye are very similar to the tissues of the joints ( more so the cartilage ) . Hence in arthritis , which result from auto-immune disorders i.e., the persons own immune system misrecognises the tissues as non self, and directs destruction due to inflammation against one's own tissues, the eyes can also get affected.

The affection of the eyes may be the result of the disease itself or the medication that is used to treat the arthritis. When the disease itself attacks the eyes the patient develops redness, pain and watering. The vision may get blurry. This results from inflammation attacking the sclera ( white of the eye ) called scleritis or episcleritis or the uvea ( the tissues that give our eyes the brown , black or blue colour of the iris ) called iridocyclitis or posterior uveitis. The pain may radiate to the brow and cause a headache and light intolerance. The vision gets misty or blurry if the inflammation affects the back of the eye ( vitreous or retina ). Either or both eyes can get affected . If the inflammation persists , the lens can get cloudy and result in a cataract, which will also blurr the vision.

Painless loss of vision may occur due to dry eyes, which is noted in 50 % of patients of sero positive and seronegative arthritis patients. Painful redness in the situation of dry eyes, heralds the possibility of an ulcer or erosion of the cornea or an ulcer i.e., a bacterial or viral infection of the cornea. Dry eye itself can be treated with artificial tear drops, ointments and the use of moisture glasses.

The different types of arthritis that can affect the eye are Rheumatoid arthritis, Juvenile inflammatory arthritis, Psoriatic Arthropathy, Gout, arthritis in Systemic Lupus erythematosus and other types of vasculitic arthritis.

The treatment of these problems includes the use of antiinflammatory steroid and nonsteroidal drops. Oral medication in the form of immunosuppressives ( as prescribed by the rheumatologist ) form the mainstay in prevention of eye diseases in patients of arthritis. Just as the joints the eyes should also be checked regularly by an Ophthalmologist trained to diagnose the problem at the soonest, in order to prevent complications like melting of the tissues and blindness.

Rarely prolonged unindicated use of eye drops containing steroids for the treatment of the red eye can result in raised pressures in the eyes and cataract. These unfortunately are often either got from 'over the counter' by a patient for red eye , just as the pain killer tablets or may be continued beyond the prescribed duration , by over sight , by the patient himself.

Hence since the implication of a red eye in a patient of arthritis can be serious and vision threatening. So, all persons suffering from arthritis are advised to undergo detailed eye examination from a consultant eye specialist rather than resort to self medication or medication from the chemists.

All efforts of the Physician and the Ophthalmologist strive towards improving the quality of life of our patients.