The Link Between Arthritis and Eye Problems

Eye problems may not seem like a logical result of arthritis. But while arthritis is primarily a joint disease, several types of arthritis and arthritis-related conditions can have systemic (body-wide) effects.

Those include some eye problems. In this article, you'll learn about three common eye conditions associated with systemic inflammatory disease.

Dry Eye Syndrome

Dry eye syndrome, also called keratitis sicca, is the most common eye problem associated with rheumatoid arthritis. It affects between 15% and 90% of people with RA.

Dry eyes are a primary symptom of Sjögren's syndrome. In Sjögren's, the immune system attacks the glands that produce moisture, including the tear glands.

Dry eyes are also common in scleroderma. This disease causes a substance called collagen to build up and harden connective tissues. The sclera (whites of your eyes) and the cornea (the clear part that covers the eye) are made of collagen, so they're vulnerable to damage from this condition.

Immunosuppressant or immunomodulatory medications may help relieve symptoms of these conditions. Eye drops are a common treatment, as well. Some people opt for punctal plugs, which are placed by a healthcare professional to block tear drainage and keep eyes moist for longer.

Uveitis

Uveitis is inflammation of the uvea that results in swelling and irritation. The uvea is the middle layer of the eye. It sits behind the cornea and sclera. It's made up of the iris (colored part) and structures called the choroid and ciliary body.

Anterior (front) uveitis is the most common type. It's associated with inflammation of the front part of the eye. If only the iris is involved, it may be called iritis.

Posterior (rear) uveitis affects the back part of the uvea, mostly the choroid. When the choroid alone is involved, it is called choroiditis. When the retina is also involved, it is called chorioretinitis.

Yet another type of uveitis is pars planitis, which is caused by inflammation of the narrowed area (pars plana) that sits between the iris and the choroid.

Symptoms of uveitis may include: 

• Blurred vision
• Eye pain
• Dark spots that float
• Sensitivity to light
• Redness of the eye

Oral corticosteroids or steroid eye drops are typically used to treat uveitis. With treatment, anterior uveitis typically goes away in a few days to weeks. Without treatment, it may result in blindness.

Posterior uveitis can last from months to years and may cause permanent damage despite treatment.

About 50% of people who develop anterior uveitis test positive for a protein called HLA-B27 that's associated with autoimmune disease (when the immune system attacks healthy tissues).

Scleritis

Scleritis is caused by inflammation of the sclera.

Granulomatosis with polyangiitis (may be early-onset) and rheumatoid arthritis (usually with long-term, seropositive RA) are typically associated with scleritis. RA accounts for between 8% and 15% of cases.

Symptoms of scleritis include:

• Blurred vision
• Severe eye pain and tenderness
• Red patches in the white areas
• Painful sensitivity to light
• Excessive watering

Severe scleritis can cause thinning of the cornea, which can lead to partial blindness.

People with scleritis can also develop other eye problems, such as:

• Uveitis
• Glaucoma
• Optic nerve edema (fluid retention)
• Retinal or choroidal distortion

If left untreated, scleritis can lead to perforation of the eyeball, which causes blindness.

Treatment of scleritis may involve:

• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Oral prednisone
• Steroid eye drops
• Local steroid injections
• Immunosuppressants, in severe cases

Even still, scleritis is often persistent, lasting for years.

Summary

Several chronic inflammatory diseases can have an impact on your eyes. Common eye conditions include dry eye syndrome, uveitis, and scleritis.

Symptoms and treatments vary depending on the condition. If left untreated, uveitis and scleritis can cause blindness.

A Word From Verywell

If you have a type of arthritis and are experiencing vision abnormalities, tell your healthcare provider. They may send you to an ophthalmologist, a physician who specializes in the diagnosis and medical treatment of eye conditions.

Delaying treatment can lead to blindness, so don't wait to get checked out. Even if you're not having eye problems, it's a good idea to get an eye exam every year. Early diagnosis and treatment may save your vision.