Lupus and The Eyes

posted in Symptoms In Lupus on December 30, 2024 by

Gavin Abson

Updated December 23, 2024

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Lupus, or systemic lupus erythematosus (SLE), is a chronic autoimmune disease that can affect multiple organs and systems, including the eyes. For individuals with lupus, maintaining eye health is vital as the disease, medications, and related conditions can contribute to eye complications. This article explores how lupus impacts the eyes, common symptoms, and strategies for monitoring and managing eye health.

According to the Lupus Encyclopedia:

Most SLE patients develop a close relationship with their eye doctors (ophthalmologists and optometrists). This is usually ­because the eyes need to be monitored and examined regularly while taking hydroxychloroquine (Plaquenil). In addition, up to half of SLE patients may develop dry eyes from Sjögren’s disease and other ­causes requiring the assistance of an eye doctor.

The Lupus Encyclopedia (2nd ed.), p. 337

What Is Lupus?

Lupus is an autoimmune disease where the immune system mistakenly attacks healthy tissues and organs, causing inflammation. While lupus most commonly affects the skin, joints, and kidneys, it can also cause significant issues with the eyes. Ongoing care is essential to minimize complications and maintain overall health.

How Lupus Affects the Eyes

Dry Eyes and Sjögren’s Syndrome

Up to half of lupus patients experience dry eyes, a condition that often occurs alongside Sjögren’s syndrome, another autoimmune disease. Dry eyes develop when the tear glands fail to produce enough moisture, leading to discomfort, irritation, and even vision problems.

Lubricating eye drops, prescription medications, and dietary adjustments can help manage symptoms. Regular visits to an eye doctor are crucial to address this common issue effectively.

Retinal Damage and Hydroxychloroquine (Plaquenil) Use

Many lupus patients rely on hydroxychloroquine (Plaquenil), a medication used to control the disease’s progression and manage symptoms. However, prolonged use can lead to a rare but serious complication called hydroxychloroquine retinopathy, which can damage the retina and affect vision permanently if left untreated.

To prevent retinal damage, patients should schedule annual screenings with an ophthalmologist and follow their doctor’s guidelines for safe medication use.

Common Eye Conditions Associated with Lupus

Inflammation-Related Eye Problems

Lupus-related inflammation can affect various parts of the eye, leading to conditions such as:

• Scleritis: Inflammation of the sclera (the white part of the eye) causing redness, pain, and light sensitivity.
• Uveitis: Inflammation of the uvea (the middle layer of the eye), potentially causing blurred vision, floaters, and pain.
• Optic Neuritis: Inflammation of the optic nerve, which can lead to sudden vision loss and color vision changes.

These conditions require prompt treatment to prevent permanent damage. Steroids or immunosuppressive medications may help manage inflammation.

Blood Vessel Complications

Lupus can also damage blood vessels in and around the eyes. Conditions such as retinal vasculitis, which involves inflammation of the retinal blood vessels, may lead to vision problems. Early detection and treatment are critical for minimizing complications.

Symptoms of Eye Involvement in Lupus

Symptoms of lupus-related eye issues can vary but may include:

• Persistent dryness or irritation
• Redness or swelling
• Sensitivity to light (photophobia)
• Blurred or distorted vision
• Sudden vision loss
• Eye pain or discomfort

If any of these symptoms occur, it’s important to consult an eye specialist promptly.

Monitoring Eye Health in Lupus Patients

Regular Eye Exams

Ongoing monitoring is crucial for lupus patients, particularly for those taking hydroxychloroquine. Ophthalmologists and optometrists play an essential role in detecting early signs of complications, allowing for timely intervention.

Annual comprehensive eye exams, including retinal screenings, can detect early damage and preserve vision.

Communication Between Specialists

Coordination between rheumatologists and eye doctors ensures comprehensive care. Rheumatologists can adjust medications if side effects affect the eyes, while eye doctors provide crucial insights into eye-related complications.

Managing Eye Issues in Lupus

Treatment Options

Effective treatment depends on the specific eye condition:

• Dry Eyes: Artificial tears, prescription eye drops, and lifestyle changes can alleviate symptoms.
• Inflammation: Steroids or immunosuppressants may reduce inflammation and prevent long-term damage.
• Retinal Damage: Adjusting Plaquenil dosage or discontinuing its use may prevent progression.

Patients should never stop taking medications without consulting their doctor, as untreated lupus can lead to severe health issues.

Lifestyle and Preventative Care

Lifestyle changes can support eye health and overall well-being. Suggestions include:

• Wearing sunglasses to protect against UV light
• Staying hydrated and eating a balanced diet
• Avoiding smoking, which worsens inflammation and increases risks

The Importance of Early Detection

Eye issues in lupus can escalate quickly without treatment. Regular exams and early symptom recognition are vital to prevent permanent vision loss. The collaboration between lupus patients and their healthcare providers is key to maintaining both eye and overall health.

Lupus can significantly impact the eyes, making proactive care essential. From managing dry eyes to monitoring Plaquenil use, early detection and intervention play critical roles in preserving vision. The Lupus Encyclopedia offers a valuable resource for understanding lupus and its effects on the eyes, empowering patients to navigate their journey with confidence.

For more information on lupus-related topics, visit Lupus Encyclopedia. Stay informed, stay empowered, and take charge of your health.

For more in-depth information on Lupus and The Eyes:

Read more in The Lupus Encyclopedia, edition 2

Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia

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