J Korean Med Assoc.  2016 Jan;59(1):45-51. 10.5124/jkma.2016.59.1.45.

Anterior segment eye diseases associated with rheumatic diseases

Affiliations
  • 1Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. jyhyon@snu.ac.kr

Abstract

Rheumatic diseases are associated various extra-articular manifestations, such as eye, nerve, pericardium, and pleura. The anterior part of the eye has distinguished anatomic structure resembling synovial joints, thus it is a common site of ocular manifestation in rheumatic disease. These changes include sicca syndrome, peripheral ulcerative keratitis, episcleritis, scleritis, and iritis. Some of these findings may be the clues for the diagnosis of the rheumatic diseases, and some ocular manifestations may represent the activity or prognosis of the rheumatic diseases. These ocular complications may leads to severe visual loss. It is crucial to rule out underlying systemic diagnosis in rheumatic disease associated ocular diseases, and when diagnosed, the coordination of the rheumatologist with the ophthalmologist in the treatment is imperative.

Keyword

Rheumatic diseases; Sjogren's syndrome; Scleritis

MeSH Terms

Corneal Ulcer
Diagnosis
Eye Diseases*
Iritis
Joints
Pericardium
Pleura
Prognosis
Rheumatic Diseases*
Scleritis
Sjogren's Syndrome

Figure

  • Figure 1 Sicca changes in the ocular surface of Sjogren's syndrome patient with patch pattern of punctate epithelial erosion and immediate break-up of the tear film.

  • Figure 2 Diffuse scleritis associated with rheumatoid arthritis.

  • Figure 3 Nodular scleritis in a 67-year-old female seropositive rheumatoid arthritis patient.

  • Figure 4 Necrotizing scelritis associated with previous pterygium surgery.

  • Figure 5 Necrotizing scleritis without inflammation (scleromalacia perforans).

  • Figure 6 Peripheral ulcerative keratitis in a rheumatoid arthritis patient. Severe thinning of the peripheral cornea eventually progressed to corneal perforation.


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