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How Rheumatoid Arthritis Could Harm Your Eyes and Your Vision

If you have rheumatoid arthritis (RA), you know your immune system attacks your joints, so you can have pain, swelling, stiffness and joint damage. 

But did you know RA can affect other parts of your body, too? It can cause issues with your skin, lungs, heart and eyes. “RA creates an inflammatory cascade that can spill over into the eye,” said Cori Jones, OD, an optometrist with Banner – University Medicine. 

Rheumatoid arthritis affects a lot of people. While anyone can develop it, RA is more common in women than men and it usually starts between the ages of 30 and 60. 

Here, we’ll dive into the ways RA can affect your eyes and what you can do to protect your eyes and keep your vision as sharp as possible. 

Eye problems connected to RA

“There are several links between rheumatoid arthritis and eye health,” said Dr. Jones.

  • Dry eyes: Dry eyes are the most common eye problem you might have with RA. That’s because RA can damage your tear glands, so you don’t make enough tears to keep your eyes moist. With dry eyes, you might notice discomfort, burning and blurred vision.
  • Scleritis: With scleritis, the white part of your eye gets inflamed. It’s a more serious condition than dry eyes and can cause vision problems if you don’t have it treated. Scleritis can cause pain, redness and swelling. A related condition, episcleritis, is when you have inflammation of the thin layer of tissue that covers the sclera.
  • Uveitis: With uveitis, the middle layer of your eye gets inflamed. It can cause vision problems like blurred vision, floaters and pain. 
  • Corneal issues: RA can damage your cornea, which is the clear front part of your eye. This damage can lead to blurred vision, pain and sensitivity to light. 
  • Retinal vasculitis: You could develop inflammation in the vessels in the retina, which is the light-sensitive tissue at the back of your eye.
  • Optic neuritis: With optic neuritis, the optic nerve (which carries information from your eye to your brain) becomes inflamed.
  • Medication-related problems: Some of the medications used to treat RA, like systemic steroids, hydroxychloroquine and immune suppressants like methotrexate, have side effects that may affect eye health and vision. 
  • Other autoimmune diseases that can affect the eyes: If you have RA, you’re at higher risk for conditions such as Sjogren’s syndrome and lupus. 

Be on the lookout for these symptoms 

These are some of the most common eye-related symptoms of RA: 

  • Dry eyes 
  • Redness 
  • Pain 
  • Itching 
  • Burning 
  • Sensitivity to light 
  • Blurred vision 
  • Fluctuating vision
  • The feeling that something is in your eye
  • Floaters (dark spots or lines in the field of vision) 
  • Changes in color vision 

“These symptoms may come and go,” Dr. Jones said. 

If you have any of these symptoms, you should see an eye doctor right away. And even if you don’t notice anything, seeing an eye doctor at least once a year is important if you have RA. Sometimes, your doctor can spot signs of eye problems before you see or feel anything.

How to treat RA-related eye problems

Treatment options for these problems depend on what condition you have and how severe it is. You may need steroids or other immunosuppressive medications. 

You can talk to your doctor about the risks and benefits of different treatments. Here are some they might want you to consider:

  • Dry eyes: Artificial tears are usually the first thing to try. If they don’t help, prescription artificial tears, punctal (tear duct) plugs that can help keep your eyes moist, blood serum tears (eye drops made from your own blood) or special contact lenses that hold tears onto the eye are options.
  • Episcleritis, scleritis, uveitis, retinal vasculitis and optic neuritis: Steroid eye drops, injections, oral steroids or other immunosuppressive medications may help reduce inflammation.
  • Corneal issues: Corneal ulcers may heal with antibiotics and eye drops. Corneal scarring may require surgery. 

You can also try these lifestyle tips that can help your eyes feel comfortable and stay healthy:

  • Apply a warm compress to your eyes for a few minutes each day. 
  • Try not to rub your eyes. 
  • Take breaks from your computer, phone and other sources of screen time. 
  • Use a humidifier and try not to use overhead fans. 
  • Don’t wear contact lenses if your eyes are dry or irritated. 
  • Use artificial tears or other eye lubricants to keep your eyes moist. 
  • Wear sunglasses to protect your eyes from the sun. 
  • Avoid smoking. 
  • Eat a healthy diet and exercise regularly. These healthy lifestyle habits can help reduce inflammation.
  • Manage your RA by taking your medications even if you are feeling OK and following your treatment plan. 

A team approach to treatment

You’ll want to work closely with your rheumatologist (the doctor who treats your arthritis) and your ophthalmologist/optometrist (the doctor who treats your eyes).

Your rheumatologist helps manage your RA and any medications that may factor into your eye problems. Your ophthalmologist or optometrist diagnoses and treats your eye problems. They work together to develop a treatment plan for your RA-related eye issues. 

Let both your rheumatologist and eye doctor know about any changes in your symptoms or health. This information will help them to provide you with the best possible care. 

At your appointments:

  • Be prepared to answer questions about your RA and any eye problems. 
  • Bring a list of all your medications, including over-the-counter (OTC) medications and herbal supplements. 
  • Tell your doctors about any side effects. 
  • Ask any questions you have about your treatment plan and why certain medications or tests are being recommended. 

The bottom line

RA can cause a range of eye problems, but living well with RA and having healthy eyes is possible. By working with your health care team, taking your medication, following your treatment plan, making healthy lifestyle choices and seeing your eye doctor for regular exams, you can protect your vision and enjoy a full and active life. 

To learn more about the link between RA and eye problems and to get personalized advice for keeping your eyes healthy, talk to your eye doctor or connect with an expert at Banner Health

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