Connection Between Arthritis and Ocular Disease

[Guest guest]

, thank you for the article on the eyes..... It is very helpful....I

have been having problems with my eyes (maybe just old age lol ) and have an

appt next week to have them checked. Will print some of these articles and

take with me.

hugs

[Guest guest]

Connection Between Arthritis and Ocular Disease

Connection Between Arthritis and Ocular Disease

C. , M.D.

The eye is made up primarily of collagen, as are ligaments, tendons, and tissue

within joint spaces. It is, perhaps, primarily because of this similarity in

composition that the eye is often affected by many of the same diseases which

affect joints. Some of these disorders include Juvenile Rheumatoid Arthritis,

Adult Rheumatoid Arthritis, Systemic Lupus Erythematosus, Relapsing

Polycondritis, Behcet's Disease, Wegener's Granulomatosis, Polyarteritis Nodosa,

and Scleroderma or systemic sclerosis. Additionally, the type of vasculature

that is present in the eye has special characteristics that produce an

extraordinarily sensitive " barometer " or " sentinel canary " in the eye for

potentially lethal vasculitis that can be associated with the aforementioned

collagen vascular diseases. Specifically, we know from considerable experience

that, despite the fact that a patient's rheumatoid arthritis may be " burned out "

as far as active inflammation of the joints in concerned, nonetheless, the

patient may well have subclinical rheumatoid vasculitis affecting various

internal organ systems. The eye is a very potent indicator of such subclinical

potentially lethal vasculitis, and if the eye becomes involved with retinal

vasculitis, uveitis, scleritis, or peripheral ulcerative keratitis in such a

patient, we take that as a very strong signal that the patient must be evaluated

extremely carefully for potentially underlying vasculitis affecting viscera and

we also take such a potentially blinding ocular lesion very seriously from the

standpoint of the need for aggressive systemic immunomodulatory therapy in order

to prevent permanent damage to the eye from such lesions.

For example, we have seen many instances in which patients with systemic lupus

erythematosus appear, systemically, to be doing quite well (indeed, the

patient's Rheumatologist has told her that she is doing very well) despite the

fact that new-onset uveitis, scleritis, or retinal vasculitis has developed in

one eye. We have seen this story evolve to life-threatening central nervous

system vasculitis and/or lupus renal disease when the onset of the ocular

inflammation was not taken as an indication for increasing the vigor of systemic

therapy. We have tried diligently, therefore, over the past 15 years to raise

the consciousness, not only of ophthalmologists worldwide, but also of

rheumatologists and other internists of the valuable indicator that the eye can

be with respect to seriousness of associated arthritic/collagen vascular

disease.

Copyright © 1998. MEEI Immunology Service