Dry, Red Eyes? Maybe It's Rheumatoid Arthritis
The RA Rundown
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that primarily affects the joints. If you have RA, your immune system mistakenly attacks the tissues in your joints. The result is inflammation, which commonly causes painful, swollen, stiff joints.
While there’s no cure for RA, treatments effectively can slow the progression of the disease, minimizing damage to joints, and relieving symptoms. The key to successful treatment is early diagnosis.
While pain, swelling, and stiffness in the joints are the primary symptoms of RA, the inflammatory response of the misfiring immune system can cause a variety of other symptoms.
If you have RA, you may also have skin problems, a greater risk for infections, and anemia. RA also can cause lung disease, heart conditions, neuropathy, an increased risk for osteoporosis, and eye problems.
RA and the Eyes
RA is the result of your immune system misfiring and the resulting inflammation can affect various parts of your body. Even your eyes are susceptible to this inflammation.
Up to one-quarter of patients with RA will experience some kind of disease in the eyes, according to the American Academy of Family Physicians (AAFP).
Symptoms of eye complications include dryness, pain, or a gritty feeling in the eyes, redness in the whites of the eyes, and blurred vision.
Do My Eye Problems Mean I Have RA?
If you have dry or red eyes, it’s possible you have the autoimmune disorder. Your symptoms could, of course, be caused by other conditions as well.
If you do have eye problems along with other symptoms of RA, like painful joints or flu-like symptoms, tell your doctor about your concerns. If you have any dryness, pain, redness, or itchiness in your eyes, regardless of other symptoms, you should see your doctor for a diagnosis.
The most common eye complaint for people with RA is dryness. The medical term for this is keratoconjunctivitis sicca. It occurs in 15 to 25 percent of RA patients, according to AAFP. This condition results from abnormalities in the tear ducts because of the actions of the immune system.
The symptoms associated with dry eyes are more common in the later part of the day, when tears from the tear duct have dried up and evaporated. Other symptoms of this condition include:
- blurred vision
- a feeling of debris in the eye
Redness in the eyes along with RA is most likely the result of scleritis. This condition occurs when the white part of the eye, known as the sclera, becomes inflamed. Redness caused by scleritis will not go away with the use of eye drops.
Scleritis also can cause pain in the eyes, light sensitivity, and reduced vision.
Uveitis is another possible complication of RA, but it’s mostly seen in the juvenile form of the disease. Uveitis occurs when the uvea, the layer between the retina and the white of the eye, becomes inflamed. Symptoms include redness, pain, light sensitivity, and blurred vision.
The majority of cases of uveitis in children are caused by RA. Uveitis is treatable, but can cause blindness if ignored.
Sjögren’s syndrome is another type of autoimmune disorder that sometimes develops alongside RA. It affects the glands in the body that produce moisture and can cause dry and itchy eyes as well as a gritty feeling, as if sand is trapped in your eyes.
Sjögren’s can cause other symptoms as well, including:
- dry mouth
- difficulty swallowing and speaking
- mouth sores
- dry and cracked skin
- swollen joints and glands
The eye complications of RA can cause further complications, most often including damage to the cornea, which is the clear layer in the front of the eye. Dry eye, scleritis, uveitis, and Sjögren’s can cause the cornea to become scratched, scarred, or ulcerated, if not treated.
If you have RA along with eye symptoms, it’s essential that you get treatment. Corneal damage can cause permanent vision loss.
Treatment for Eye Complications
While many possible eye complications are associated with RA, they can all be controlled with proper treatment. Early detection is important, as is treatment for RA. If your RA is well controlled by medications, you’ll be less likely to develop these eye disorders.
In addition to your RA medications, your doctor can help you treat your eye symptoms. Eye drops can help relieve dryness, and topical corticosteroids can relieve redness and itching. For deeper inflammations, corticosteroids injections can help.
● Arthritis and your eyes. (2013). Arthritis Foundation. Retrieved December 17, 2013, from http://www.arthritistoday.org/about-arthritis/arthritis-and-your-health/arthritis-and-your-eyes/eye-arthritis.php
● Patel, S.J. and Lundy, D.C. (2002). Ocular Manifestations of Autoimmune Disease. American Family Physician,15, 66(6), 991-998. Retrieved December 17, 2013, from http://www.aafp.org/afp/2002/0915/p991.html
● Rheumatoid arthritis and eye conditions. (2009, August 31). Hospital for Special Surgery. Retrieved December 17, 2013, from http://www.hss.edu/conditions_rheumatoid-arthritis-eye-concerns.asp
● What is Sjögren’s syndrome? (2013). Arthritis Foundation. Retrieved December 17, 2013, from http://www.arthritistoday.org/about-arthritis/types-of-arthritis/sjogrens-syndrome/what-you-need-to-know/sjogrens-syndrome-diagnosis.php