About one-third of people with lupus experience eye problems.
The most common lupus eye problem isdry eye syndrome, affecting about 25% of people with lupus.
Dry Eye Disease
People with lupus commonly develop dry eye syndrome (keratoconjunctivitis sicca).
Illustration by JR Bee, Verywell
In fact, as many as 25% of people with lupus eventually develop dry eyes.
Eye pain, itching, burning, and sensitivity to light are also common.
Many people with lupus also haveSjogrens disease, a condition characterized by dry eyes and mouth.
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However, dry eye syndrome can develop in people with lupus regardless of whether they have Sjogrens disease.
Corneal Ulceration
Another complication of lupus affecting the eyes is corneal ulceration.
In people with lupus, corneal ulceration usually develops as a result of dry eye syndrome.
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Tears contain essential nutrients that protect the cornea and help it heal.
Without enough tears, the cornea takes longer to repair itself, increasing the risk of ulcers and infections.
Corticosteroid eye dropsmay be prescribed to reduce inflammation.
Lubricating eye drops may also be prescribed to keep the eye moist and promote healing.
Discoid Lupus Erythematosus
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The rash is made up of scaly, disc-shaped lesions that mostly appear on sun-exposed areas of skin.
The discoid lesions usually respond well to oral steroids, althoughcortisone injectionsmay be used for more severe cases.
Retinal Vasculitis
Retinal vasculitis is a complication of lupus in which the blood supply to theretinais reduced.
Vasculitis refers to the inflammation of blood vessels.
Unfortunately, the new blood vessels are weak and prone to breakage or leakage.
This can cause swelling of the retina, leading to blind spots and a painless decrease in vision.
Immunosuppressant drugs can help treat the underlying autoimmune response.
Scleritis
Lupus can also causescleritis.
Thesclerais the white, tough outer coating of the eyeball.
Scleritis shows up when the sclera becomes inflamed.
Over time, scleritis can cause the sclera to thin, creating weakened areas that can perforate.
Up to 5% of people with lupus develop uveitis.
In people with lupus, uveitis typically manifests in the form of choroiditis, or inflammation of the choroid.
Located towards the back of the uvea, the choroid is responsible for supplying the retina with blood.
Retinal detachment can lead to blindness unless treated promptly.
Choroiditis often responds well to systemic corticosteroids, which may be administered orally or by IV.
Milder cases may be treated with corticosteroid eye drops administered directly into the affected eye.
Prompt immunosuppressive therapy may also be necessary.
CRAO is considered a form ofischemic stroke.
Treatment may involve medications to reduce eye pressure or dissolve blood clots.
Optic Neuritis or Neuropathy
Less commonly, people with lupus may developoptic neuritis.
While only one eye is usually affected, the damage can often be severe.
Optic neuropathy is a similar condition that causes the blockage of blood vessels servicing the optic nerve.
Some people refer to this as aneye stroke.
An eye stroke is a serious medical condition that requires immediate medical care.
Intravitreal steroid injections are commonly used to treat both conditions.
With optic neuropathy,anticoagulants(blood thinners) may be prescribed to prevent blockages in the unaffected eye.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
The treatment of lupus-related eye conditions may be as simple as artificial tears.
In other cases, oral steroids, topical steroids, or intravitreal steroid injections may be needed.
Immunosuppressant drugs may also be prescribed to treat the underlying autoimmune response.
Shoughy SS, Tabbara KF.Ocular findings in systemic lupus erythematosus.Saudi J Ophthalmol.
2016;30(2):117121. doi:10.1016/j.sjopt.2016.02.001
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Sjogrens disease.
Lupus Foundation of America.How lupus affects the eyes.
American Osteopathic College of Dermatology.Discoid lupus erythematosus.
2021 Mar;52(6).
