Autoimmune diseases affect millions of Americans. You may have heard of some of these: Rheumatoid arthritis, Lupus, Sjögren’s syndrome, Graves’ disease, Crohn’s disease, Celiac disease, or Lyme disease. According to the American Autoimmune Related Diseases Association, there are over 100 known autoimmune diseases.
So, what exactly is an autoimmune disease? Our bodies have a built-in defense-against-disease mechanism called the immune system. It helps us to fight off viruses, bad bacteria, germs, cancer cells, and the like. Sometimes though, this same protective system can get confused and start attacking the body even when it is well. This is what is known as autoimmunity. Various diseases, like the ones mentioned above, can develop. Often times, the eyes are one of the first areas to be noticeably affected – along with joint and muscle pain, fatigue, and other conditions specific to the disease.
How Autoimmune Diseases Affect the Eyes
There are several ways that autoimmune diseases affect the eyes, below are just a few conditions that can develop. It is important that you speak with your eye care provider and follow up with any referrals to other professionals they make to fully determine if an autoimmune disease is an underlying cause.
A common complaint for those with autoimmune diseases is dry eye, also known as Keratoconjunctivitis Sicca. This is a tricky one because nearly half of all American adults experience dry eye syndrome regularly. So, how to know when it’s just “regular” dry eye versus “autoimmune disease” dry eye? That can usually be determined by your eye care provider asking follow-up questions related to other generally known symptoms and referring you to a specialist or to your primary care physician for a more thorough check-up.
Other parts of the eye can be affected too. Anterior Uveitis, for example, is an inflammation of the iris (the colored area of the eye). Along with eye redness and sensitivity to light, anterior uveitis brings blurred vision and dark, floating spots in the vision as well. Autoimmune diseases like Rheumatoid arthritis and Ankylosing Spondylitis often present with anterior uveitis. Another condition that affects the surrounding tissue next to the iris is Peripheral Uveitis (also called Pars Planitis). This inflammation impacts the tissue next to the iris that makes the fluid that nourishes the lens and cornea. It affects mostly young men and is sometimes associated with Crohn’s disease; some experts suggest Lyme disease as well.
Scleritis is an inflammation of the deeper tissue of the eye (sclera). It presents with extremely painful redness across the white portion of the eye. Blurred vision, light sensitivity, and watery eyes are also often present with this condition. Rheumatoid arthritis and Lupus are two of the major autoimmune diseases that can affect the sclera. If not addressed, it can lead to vision loss, so it is important to get it checked out.
The cornea is another area of the eye that can become inflamed. This is called Keratitis and may cause a corneal ulcer. Rheumatoid arthritis, Lupus, and Sjögren’s syndrome are just a few of the autoimmune culprits of this condition.
Optic Neuritis is an inflammation of the optic nerve. Multiple Sclerosis and Lupus are two of the more common autoimmune disorders that can affect the optic nerve. Patients with this condition typically have pain with eye movement, blurred vision, difficulty seeing at night, and aren’t able to see colors accurately.
Red eyes, caused by inflammation of the superficial sclera (white part of the eye) is usually benign and not painful. This condition is called Episcleritis and can be found in patients with Rheumatoid arthritis, Crohn’s disease, ulcerative colitis, Lupus, among many others.
And finally (for the purposes of this blog post), Exophthalmos is a condition where the eyes protrude or bulge outward, as is seen in autoimmune diseases like Graves’ disease. It can cause double vision for some but permanent vision impairment is rare if caught early and treated.
Again, these are but a few of the conditions that can develop as a result of an autoimmune disease.