According to the websitereviewofoptometry.com, “Inflammation plays a key role in severe dry eye syndrome and can be brought about by four common autoimmune conditions. Patients who suffer from rheumatoid arthritis, Sjögren's syndrome, rosacea, and systemic lupus erythematosus frequently experience dry eye. In these cases, the autoimmune disease actually targets ocular surface tissue prior to the onset of dry eye symptoms.”
Rheumatoid arthritis or “RA” is a highly inflammatory disease that can often lead to joint decay, deformity, and/or loss of functionality. Swelling of the joints is the benchmark of this disease. RA can cause irreversible joint damage and disability. 1% of the population is diagnosed with RA and experts say the condition affects twice as many women as it does men.
When severe oral and eye symptoms are combined with ocular signs and salivary gland involvement, Sjögren’s syndrome may be diagnosed in conjunction with the RA. This is known as secondary Sjögren’s.
Dry eye symptoms are more common in patients with RA, and tend to increase with age. Dry eye syndrome is also associated with certain medications, and the severity of the case of RA itself. About 25% of patients with RA will have dry eye-related problems. Some of the eye problems associated with RA include the following, but are not limited to:
Dry eye has a strong association with Sjögren’s syndrome, which leads to a tear-deficient type of dry eye syndrome. Sjögren’s syndrome is a chronic autoimmune disorder that affects both tear production and the function of the salivary glands. This disorder actually attacks both the salivary glands and the lacrimal glands responsible for tear production.
Sjögren’s syndrome could lead to chronic irritation and subsequent damage to the cornea. The eye symptoms and signs of Sjögren’s include the following:
Complications may include corneal ulceration, scarring and eyelid infections.
Rosacea is a chronic inflammatory disease of the skin characterized by certain facial blood vessels enlarging, giving the cheeks and nose a flushed appearance. It affects around 14 million people in the United States. Rosacea usually starts around the age of 20 to 30, with a noticeable progression within the next decade after it begins.
Eye signs and symptoms of rosacea are very common and may include:
Systemic Lupus Erythematosus
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown origin. It can affect many organs in the body. SLE can exhibit eye symptoms in one-third of patients. Eye involvement in SLE can be a potentially blinding condition. SLE can affect the blood vessels of the various parts of the eye, including the retina, sclera, and cornea.
Artificial tear methods can be used to alleviate symptoms in patients with mild eye problems from these autoimmune diseases. More serious cases should be treated with stronger medications, including the use of anti-inflammatory agents like corticosteroids. New pharmaceutical options such as Xiidra may also be of use.
RA, Sjögren’s syndrome, rosacea and SLE are just a few examples of autoimmune diseases that can have severe systemic and eye problems. Other diseases that can cause dry eye are multiple sclerosis, thyroid diseases, psoriasis, Grave’s disease, ulcerative colitis and Type I (juvenile) diabetes. Do you suffer from any of the four conditions above? Do you experience dry eyes?
Dr. Jenna Zigler