The body’s systems are interconnected, so any disease or medical condition can affect eye health and vision. Autoimmune disorders are no exception.
5 Common Ways Autoimmune Disorders Impact Eye Health
In addition to any direct effect an autoimmune system might have on a patient’s eyes or vision, the hyperinflammation inherent in many of these conditions is evidenced in our patients’ eye exams. This is one of the reasons ophthalmologists and optometrists often detect health issues before a patient’s official diagnosis.
Autoimmune Disorders Most Likely To Affect Vision
Here is a list of some of the most likely autoimmune disorders to cause eye or vision problems:
- Rheumatoid arthritis
- Multiple sclerosis (MS)
- Thyroid diseases
Other autoimmune disorders that can cause eye issues are:
- Lupus
- Sjögren’s syndrome (now referred to as Sjögren’s disease or SJD)
- Inflammatory bowel diseases like ulcerative colitis or Crohn’s disease
In some cases, rare autoimmune disorders may affect eye and vision health. This is why we recommend more frequent eye exams depending on our patient’s medical history and lifestyle. We typically see the effects of autoimmune disorders in one of five ways.
Dry eyes
This eye condition is increasingly common. In addition to medical conditions that cause dry eye, we treat patients with dry eye due to excess screen use without ample breaks, age, or after menopause. In the case of autoimmune disorders, dry eye results from the body’s attack on its own mucous membranes, and this causes decreased lubrication.
Dry eye is one of the predominant symptoms of Sjögren’s disease, although it can also manifest from other autoimmune disorders or health conditions. Dry eye is treated depending on the severity of the symptoms. In some cases, special attention to diet, hydration, and using lubricating eye drops is sufficient to treat the symptoms. In other cases, we use prescription eyedrops or ointments to support patient comfort.
Uveitis (chorioretinitis)
We’ve written about uveitis in the past. It occurs when the middle layer of the eye, called the uvea, becomes inflamed. At first, many patients with uveitis assume they have an eye infection and wait for it to calm down on its own. However, uveitis requires treatment by an optometrist.
There are multiple types of uveitis. If an autoimmune disorder causes it, the type of uveitis you have is an indicator of the cause. For example, anterior uveitis is often caused by inflammatory bowel disease (IBD). In children with rheumatoid arthritis, anterior uveitis can be painful. This is another reminder to get treatment for any unexplained redness, irritation, or light sensitivity in the eyes that doesn’t clear up within a reasonable amount of time (two weeks or less).
Those with multiple sclerosis are more prone to intermediate uveitis or pars plantitis. We are unsure whether MS causes this condition or whether people with MS are more prone to it. Finally, people with lupus or sarcoidosis are at higher risk for developing posterior uveitis or inflammation of the rear side of the uvea. Depending on the location, symptoms, and medical history, prescription steroid drops or steroid injections are the most common treatment for all forms of uveitis.
Scleritis
The sclera is the white part of the eye. If this becomes inflamed, it’s called scleritis. It is a common ailment for those with rheumatoid arthritis. However, we also see more frequent cases of scleritis in patients who have IBD, lupus, Sjogren’s syndrome, Polyangiitis (formerly Wegener’s), and scleroderma.
In addition to causing redness, scleritis is very painful. Patients describe it as a deep aching pain. Treatment is essential because chronic scleritis weakens the sclera, which can eventually tear or open up, causing permanent vision damage. We treat scleritis using a combination of steroid eye drops and steroidal and non-steroidal oral inflammatory medications.
Optic neuritis
The suffix -itis refers to inflammation. So, you may notice a theme here. Autoimmune disorders are associated with elevated inflammation throughout the body, sometimes including the eye or related anatomical parts. In the case of optic neuritis, the optic nerve connecting the eye to the brain becomes inflamed.
While people without autoimmune disorders can develop optic neuritis, those with MS are particularly susceptible to the condition, and it is often one of the first symptoms of the disease. Lupus also increases the risk of optic neuritis.
Grave’s eye disease
Grave’s disease is an autoimmune disorder that causes the body to attack the thyroid gland. Sometimes, the same cells that attach to the thyroid also attack cells in the eye. Also called thyroid eye disease (TED), Grave’s eye disease causes a range of symptoms. One of the most common is a bulging of the eyes, caused by swelling in the muscles around the eyes.
Standard treatment for TED is lubricating eye drops for relief, as well as steroidal treatments via drops, oral medications, or IV. Lately, passive immunotherapy in the form of monoclonal antibodies has also shown success in managing Grave’s eye disease.
Lifestyle Choices Are Critical In Managing Autoimmune Disorders Affecting The Eyes
Lifestyle choices are especially important when managing autoimmune disorders that affect the eyes or contribute to vision loss. For example, anti-inflammatory diets are instrumental in managing widespread inflammation. These diets, which focus on whole foods, minimizing processed foods, and sugar, and emphasizing lean proteins, help to keep the body’s inflammation levels in check, which soothes the inflammatory response.
Focusing on healthy sleep habits also helps to boost healthy immune system responses while quelling the hyper-inflammatory response that triggers flare-ups.
Atlantic Eye Institute Takes a Well-Rounded Approach to Autoimmune Disease
The team of optometrists and ophthalmologists at Atlantic Eye Institute know our patients deserve a well-rounded and connected response to their autoimmune diagnosis and treatment plans. We work with you, your physician, and your specialist to support vision and eye health while making sure you have all of the information and support you need to manage your condition.
Schedule an appointment with us and you’ll see the difference.