The Eyes

Eye disease occurs in approximately 20 percent of patients with SLE. In some cases, eye problems are related to the inflammatory process of lupus itself. In other cases problems may be due to drug treatment (corticosteroids or antimalarials) or may be a separate problem (glaucoma or retinal detachment). Blindness due to SLE occurs, but is rare.

The following eye problems occur in lupus:

• A lupus rash may develop on the eyelids.
• Kerato-conjunctivitis is "dry eye" related to Sjögren’s syndrome. Some people with lupus have Sjögren’s syndrome, which is an autoimmune condition that causes excessive dryness of the mucous membranes. People with lupus who have these symptoms require artificial tears to relieve dry eyes.
• Uveitis (inflammation of the iris, ciliary body, vitreous gel and/or choroid) and scleritis may be part of the systemic inflammatory process of the disease.
• Cytoid bodies are the most common retinal change in SLE. They reflect microangiopathy of the retinal capillaries and localized microinfarction of the superficial nerve fiber layers of the retina.
• Glaucoma and cataracts may be caused by corticosteroids.
• Antimalarials can damage the retina, which can impair vision (particularly color vision) or, extremely rarely, cause blindness. The risk of retinopathy is as low as 1 in 5,000.

Changes in vision can be a result of lupus or because of the corticosteroids and antimalarials used to treat lupus. Problems can include inflammation of the eye, glaucoma, cataracts, general changes in vision, and blocked tear ducts. On very rare occasions, blindness can result. Warning signs include:

• a lupus rash on the eyelids
• a sore, red eyes
• loss of tears, dry eyes
• mucus discharge from eyes, particularly upon awakening
• sensitivity to light
• headaches
• change in vision
• blurred vision
• cloudy lens(es)
• burning sensation in eyes
• lack of tears, and eyes that hurt and are dry
• episodes of flashing lights and partial blindness.

Potential Problems When Your Eyes are Affected by Lupus

1. discomfort
2. visual impairment
3. potential for injury
4. difficulty carrying out activities of daily living

The above information has been developed by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

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