Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by inflammation and pain in the joints. It primarily affects the joints, but can also involve other organs and tissues in the body.

Although primarily a joint disease, RA can also have ocular manifestations, with corneal complications being one of them. In this article, we will explore the connection between rheumatoid arthritis and corneal complications, including the symptoms, causes, and treatment options.

What is rheumatoid arthritis?

Rheumatoid arthritis is an autoimmune disease in which the immune system mistakenly attacks the synovium, which is the membrane that lines the joints. This leads to chronic inflammation, pain, and joint damage.

It primarily affects the small joints of the hands, feet, wrists, and ankles, but can also involve other joints in the body.

Corneal complications in rheumatoid arthritis

Although RA primarily affects the joints, it can also have ocular manifestations, including corneal complications. The cornea is the clear, dome-shaped outer layer of the eye that helps focus light and protect the eye from dirt and germs.

Inflammation in the eyes can lead to various corneal complications, such as:.

1. Dryness and irritation

Many individuals with rheumatoid arthritis experience dry eyes due to decreased tear production and increased tear evaporation. This can lead to eye discomfort, redness, and a gritty or burning sensation in the eyes.

2. Scleritis

Scleritis is inflammation of the sclera, which is the white part of the eye. It can cause severe eye pain, redness, and blurred vision. Scleritis is more commonly associated with RA compared to other types of arthritis.

3. Keratitis

Keratitis is inflammation of the cornea. It can cause eye pain, redness, blurred vision, and sensitivity to light. Inflammatory cells and deposits may be visible on the cornea.

4. Uveitis

Uveitis is inflammation of the uvea, which is the middle layer of the eye. It can cause eye redness, pain, light sensitivity, and blurred vision. Uveitis can be anterior (affecting the front of the eye) or posterior (affecting the back of the eye).

5. Episcleritis

Episcleritis is inflammation of the episclera, which is a thin layer between the sclera and the conjunctiva. It can cause redness, discomfort, and watery eyes.

Causes and risk factors

The exact cause of corneal complications in rheumatoid arthritis is not fully understood. However, it is believed that the autoimmune response involved in RA can also affect the eyes.

The inflammation in the joints may spread to the eyes or eye-related tissues, leading to various corneal complications. Additionally, the use of certain medications to treat RA, such as corticosteroids, can increase the risk of developing ocular complications.

Symptoms

The symptoms of corneal complications in rheumatoid arthritis can vary depending on the specific condition. However, common symptoms may include:.

Eye redness
Eye pain
Blurred vision
Light sensitivity
Dryness
Irritation or a gritty sensation in the eyes

Diagnosis and treatment

If you have rheumatoid arthritis and experience any eye-related symptoms, it is important to seek medical attention. An ophthalmologist will perform a comprehensive eye examination to diagnose any corneal complications. The examination may include:.

Visual acuity test
Slit-lamp examination
Tonometry to measure intraocular pressure
Fluorescein eye stain to evaluate the cornea
Ocular ultrasound, if necessary

Treatment for corneal complications in rheumatoid arthritis may vary depending on the specific condition and severity of symptoms. Some common treatment options include:.

Artificial tears or lubricating eye drops to relieve dryness
Anti-inflammatory eye drops or ointments
Oral medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
Immune-suppressing medications, such as corticosteroids or disease-modifying antirheumatic drugs (DMARDs)
In severe cases, surgery or other advanced treatment options may be necessary

Prevention

While it may not be possible to completely prevent corneal complications in rheumatoid arthritis, there are steps you can take to reduce the risk and manage symptoms:.