autoimmune disease blog

Monitoring eye health in lupus patients is important. First, lupus ocular complications are potentially blinding and second, eye symptoms are an indication of less obvious disease activity, such as kidney damage, that tends to occur in cycles of exacerbation and remission. Medications used to treat lupus disease can have widely side effects involving the eye, but the disease itself can cause much more damage to the eye system. Thus eye health can be useful in finding the dosage of medication to optimize the balance between its benefits and risk.

Lupus can damage almost any part of the eye. The mechanisms include inflammation of the blood vessels, immune complex deposition, antibody dependent cytotoxicity and blood clots. Below are the types of eye problem that may cause by lupus:

1. Anterior segment disease. White of the eye can become inflammed enough to cause severe pain. The cornea can be damaged by recurrent corneal erosions, loss of epithelial tissue and inflammation. In less common cases, conjunctivitis (pink eye) may be caused by lupus. Pain is generally a symptom of disease of the front part of the eye (anterior segment), while visual loss generally indicates problems with the back part of the eye (posterior segment).
2. Neuro-ophthalmic disease. Abnormalities of the pupil may indicate lupus disease activity. Both the nerves and the optic nerve that control eye motion can be affected.
3. External eye disease. The lacrimal (tear) gland can be damaged by antibody dependent mechanisms, causing dry eye from secondary Sjogren’s syndrome. Discoid lupus-type rash may develop over the eyelids. In less common cases, the space around the eye can be damaged by orbital masses, inflammation or fluid accumulation.
4. Ophthalmic disease as a side effect of treatment. Corticosteroids are commonly used to treat lupus. They are highly effective, but may cause cataracts and glaucoma.
5. Posterior segment disease. Both the choroid and retina can be damaged, leading to blinding.