The hallmark of arthritis is inflammation of the joints, but the condition can also affect other parts of the body, including the eyes.
About 1 in 4 adults in the United States have a diagnosis of some form of arthritis. The condition can affect people of any age or sex and seriously affect their quality of life.
There are more than 100 types of arthritis, and they all involve inflammation. Some types, including rheumatoid arthritis,
Most people who experience arthritis-related eye problems are female. When eye problems occur, they usually affect both eyes. These eye problems tend to worsen as arthritis progresses.
Several eye conditions can occur with different forms of arthritis.
Keratitis sicca
Keratitis sicca, commonly known as dry eye syndrome, is when the eyes stop producing enough tears to keep them moist. It affects females
Risk factors:
- rheumatoid arthritis
- Sjögren’s disease
- other autoimmune diseases
Symptoms:
- dryness
- a sensation of something in the eye
- blurred vision
Treatment:
- controlling arthritic inflammation with arthritis medication
- applying a topical ointment before going to bed
- using artificial tears or eye drops to keep the eyes moist
- trying a humidifier at night in the bedroom
- using punctal plugs, which are devices that prevent the tear ducts from draining
- asking a doctor about prescription dry eye medication, such as lifitegrast (Xiidra) or cyclosporine (Restasis)
Scleritis
Scleritis is inflammation of the sclera, which is the white part of the eye. It can lead to the sclera or the cornea becoming too thin, and people might experience reduced vision, cataracts, and other complications.
Scleritis can be a sign that a person’s inflammation levels are high. They may need to adjust their arthritis treatment.
Risk factors:
- rheumatoid arthritis inflammation
- relapsing polychondritis and granulomatosis with polyangiitis, formerly known as Wegener’s granulomatosis
- conditions
that affect the blood vessels throughout the body - other autoimmune diseases
Symptoms:
- redness that does not go away despite the use of over-the-counter eye drops
- severe pain
- sensitivity to light
- reduced vision
Treatment:
- oral corticosteroids
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- other oral or intravenous medications to reduce inflammation
Uveitis
Uveitis is inflammation of the uvea, the vascular area of the eye between the retina and the sclera. Without treatment, it can lead to vision loss. Often the cause is unclear, but there seems to be
Risk factors:
- juvenile idiopathic arthritis
- ankylosing spondylitis
- psoriatic arthritis
- reactive arthritis
- Behçet’s disease
- infections
- trauma
Symptoms:
- pain
- redness
- blurred vision
- sensitivity to light
- risk of permanent vision loss, particularly in children
Treatment:
- corticosteroid eye drops
- oral corticosteroid or corticosteroid injection into the eye
- antibiotics, if an infection occurs
Cataracts
Cataracts occur when inflammation of the eyeball causes the lens to cloud over. The lens in an unaffected eye is usually clear. The condition
Risk factors:
- rheumatoid arthritis
- ankylosing spondylitis
- psoriatic arthritis
- type 2 diabetes
- repeated episodes of uveitis
- older age
- a family history of cataracts
Symptoms:
- cloudy or blurred vision
- poor vision at night
- colors appearing faded
Treatment:
- specific glasses to improve eyesight
- surgery to remove the cloudy lens and replace it with an artificial one
Eyedrops are also
Glaucoma
Glaucoma involves damage to the optic nerve because of high pressure inside the eye. If the channels that usually drain fluid from the eye become inflamed, pressure can build up. Without treatment, glaucoma can lead to vision loss. However, treatment
Risk factors:
- ankylosing spondylitis
- juvenile idiopathic arthritis
- other types of inflammatory arthritis
- side effects of corticosteroid therapy for arthritis
Symptoms:
There are typically no symptoms in the early stages. Later on, a person may experience:
- pain
- blurred vision
- blank spots in the vision
- seeing a rainbow-colored halo around lights
Treatment:
- eye drops
- surgery to lower pressure
- reducing or avoiding corticosteroid use
Retinal vascular occlusion
If the blood vessels leading to the retina become blocked, this can cause retinal vascular occlusion. Depending on the affected vessel, this can be either retinal artery occlusion or retinal vein occlusion. The blocked vessels can no longer deliver blood — and therefore oxygen — to the eyes. As a result, damage can occur.
Risk factors:
- lupus
- scleroderma
- Behçet’s disease
- sarcoidosis
- polyarteritis nodosa
Symptoms:
- a blind spot in a person’s vision
- vision loss that comes and goes suddenly
- gradual vision loss
Treatment
In some cases, when a vein becomes blocked, no treatment is necessary. The blockage
If an artery becomes blocked, a doctor may attempt to lower the pressure in the eye
Conjunctivitis
Conjunctivitis refers to the inflammation of the lining of the eyelids and the white of the eyes, which can result from infection. It usually lasts
Risk factors include:
- reactive arthritis
- inflammation due to a bacterial or viral infection
- allergic reactions
Symptoms:
- red eye or inner lid
- increase in tears
- yellow discharge that crusts around the eye
- itchy or burning eyes
Treatment:
- antibiotics, if a bacterial infection is present
- steroids to help reduce inflammation
- cold compresses
- artificial tears
Although there are about 100 different types of arthritis and related diseases, not all of them are linked to eye conditions.
The common types of arthritis
Rheumatoid arthritis
Rheumatoid arthritis is an autoimmune disease, which means that the body’s immune system mistakenly attacks healthy cells, leading to pain and inflammation.
Rheumatoid arthritis attacks the lining of the joints. Over time, the resulting inflammation damages the joints permanently and causes severe pain.
Osteoarthritis
Osteoarthritis is a “wear-and-tear” disease that occurs when the protective cartilage between the joints breaks down, making movement more difficult and painful. This type of arthritis does not usually increase a person’s risk of eye conditions.
Fibromyalgia
People with fibromyalgia experience pain differently than other people and may be more sensitive to pain.
A person may have widespread pain, which can be constant or intermittent. They may also experience fatigue, problems with sleeping and concentrating, and anxiety.
Gout
Gout is a form of inflammatory arthritis that occurs when the body produces excess uric acid, which forms crystals in the joints. The crystals cause pain and inflammation and often affect the big toe, although people can have symptoms in other joints.
Psoriatic arthritis
Psoriatic arthritis is an autoimmune inflammatory disease that is
Ankylosing spondylitis
A person with ankylosing spondylitis will have inflammation in the joints and ligaments of the spine. Over time, the vertebrae may fuse.
If a person with arthritis is experiencing any changes in their vision or has concerns about their eyes, they should consult an eye doctor.
Anyone using the drug hydroxychloroquine (Plaquenil) for rheumatoid disease will need regular eye checks to ensure that the medication is not affecting the health of their macula, which is the center of the retina.
Early diagnosis and treatment can often help prevent further damage to the eyes and reduce the likelihood of vision loss.
There are different types of arthritis, which primarily affect the joints. However, a person may also develop eye problems, especially with rheumatoid arthritis.
Possible problems include dry eye syndrome, scleritis, uveitis, glaucoma, retinal vascular occlusion, and conjunctivitis.
Anyone with arthritis who notices eye problems should seek medical advice. In some cases, early treatment can help prevent complications and possible vision loss.