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Rheumatoid Arthritis and How It Can Affect Your Eyes

Arthritis is a common condition in which your body’s immune system mistakes your joints as foreign or dangerous tissue and “sends in the troops” to attack the joint and surrounding tissue. Your immune system is essentially your body’s police force with the task of detecting and killing foreign invaders such as bacteria and viruses and internal invaders such as certain types of cancer. The majority of these efforts are done by white blood cells which are the generals and warriors of the immune system. These cells essentially “read” the molecular patterns on cell walls to determine friend or foe. If the patterns are not recognized as belonging to your body, its time to get out a can of whoop ass.

Unfortunately, your immune system isn’t always perfect. It gets confused and attacks your body’s friendly cells and tissues. This confusion and misreading of the cells surface are the basis for many autoimmune inflammatory conditions such as arthritis.

It is not uncommon for someone with arthritis to have other inflammatory problems. The reason for this is because the confused immune system not only sets it sights on the joints but also other tissues including the eyes. The most common eye related inflammatory condition is “iritis” or inflammation of the iris.

The hallmark symptom of iritis is usually PAIN and is often described as dull, boring, and similar to getting punched in the eye. The sclera (white part of the eye) is usually red immediately next to the iris. Vision is often mildly blurry in the affected eye. Light sensitivity is usually present and often intense. This condition is often misdiagnosed as simple pink eye or conjunctivitis and treated with antibiotics that are not effective for iritis which is an inflammation, not an infection. Iritis and other eye conditions require an examination by an Optometrist for proper diagnosis.

Treatments for this condition vary upon the severity of the condition. Early and proper diagnosis are key in the effectiveness of treatment. If left untreated, iritis can lead to severe and permanent vision loss. Mild to moderate cases of iritis are usually effectively treated with steroid eyedrops and pupil dilation drops. The steroid drops reduce the inflammation by calming the immune system and directing it to call off the troops. The dilation drops relax the iris and allow it to heal. Unfortunately, iritis patients will often have a dilated pupil(s) for several days or weeks. In more severe cases of iritis in which the inflammation has moved further into the eye (uveititis), steroid injections into the eye are often needed.

Iritis is much more common in patients with juvenile rheumatoid arthritis (JRA) than age related arthritis. Children with JRA should have an iris examination by an eye doctor every six months as they can sometimes develop an underlying low grade iritis with minimal or no symptoms. Other autoimmune diseases such as Crohn’s Disease, Multiple Sclerosis, Sarcoidosis, can also be associated with iritis.

Please click here for more information on iritis.

Thanks for reading and let us know if you have any questions!

Dr. Steve