Table of ContentsView AllTable of ContentsDry Eye DiseaseCorneal UlcerationDiscoid Lupus ErythematosusRetinal VasculitisScleritisUveitis and ChoroiditisCentral Retinal Artery OcclusionOptic Neuritis or Neuropathy
Table of ContentsView All
View All
Table of Contents
Dry Eye Disease
Corneal Ulceration
Discoid Lupus Erythematosus
Retinal Vasculitis
Scleritis
Uveitis and Choroiditis
Central Retinal Artery Occlusion
Optic Neuritis or Neuropathy
Lupus can affect the eyes, eyelids, the skin around the eyes, and the nerves and blood vessels supplying the eyes. 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.
People with dry eyes due to lupus may experience eye irritation, redness, and pain, an open sore on the cornea (corneal ulcer), and a sensation of something stuck in the eye.About 10% of people with lupus develop retinal disease, which can lead to vision loss and blindness.As with most lupus symptoms, lupus-related eye problems range from mild to severe.
People with lupus commonly develop dry eye syndrome (keratoconjunctivitis sicca). In fact, as many as 25% of people with lupus eventually develop dry eyes.
Dry eye syndrome develops in people with lupus when the immune system attacks thelacrimal glands, or the glands responsible for making tears.
When the lacrimal glands get damaged, the eyes lose their ability to self-lubricate, leading to dry and inflamed eyes. Eye pain, itching, burning, and sensitivity to light are also common.
Artificial tearsare commonly prescribed to lubricate the eyes and prevent eye damage.Immunosuppressant drugsmay be used to treat the underlying autoimmune response.
Another complication of lupus affecting the eyes is corneal ulceration. Thecorneais the clear, outer layer of the eye that helps focus light so you can see clearly.
In people with lupus, corneal ulceration usually develops as a result of dry eye syndrome. Over time, dryness and increased friction can damage the cornea, making it more vulnerable to cuts and scratches.
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.
If the corneal ulceration is infected, it may be treated with antibiotic, antifungal, or antiviral eye drops, depending on the type of infection.
Corticosteroid eye dropsmay be prescribed to reduce inflammation. Lubricating eye drops may also be prescribed to keep the eye moist and promote healing.
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from ©DermNet NZ and ©Waikato District Health Board www.dermnetnz.org 2022
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from ©DermNet NZ and ©Waikato District Health Board www.dermnetnz.org 2022
People with lupus often develop a skin condition calleddiscoid lupus erythematosuswhich appears as a thickenedrash over the eyelids.
The rash is made up of scaly, disc-shaped lesions that mostly appear on sun-exposed areas of skin. The condition tends to favor the face, ears, and scalp but can develop on other parts of the body.
Discoid lupus erythematosus tends to run in families, with females outnumbering males three to one.Cigarette smoking and sun exposure can trigger an outbreak.
The discoid lesions usually respond well to oral steroids, althoughcortisone injectionsmay be used for more severe cases.
Retinal vasculitis is a complication of lupus in which the blood supply to theretinais reduced. Vasculitis refers to the inflammation of blood vessels.
The retina is the layer of cells on the back of the eye that senses light and sends signals to the brain so that you can see.
Oral steroids or intravitreal steroid injections (delivered to the inner gel of the eye) may be used to treat retinal vasculitis. Immunosuppressant drugs can help treat the underlying autoimmune response.
Lupus can also causescleritis. Thesclerais the white, tough outer coating of the eyeball. Scleritis occurs when the sclera becomes inflamed. Over time, scleritis can cause the sclera to thin, creating weakened areas that can perforate.
For most people, scleritis causes pain, light sensitivity, blurred vision, eye redness, or dark patches on the sclera. But when scleritis is severe, even a minor trauma can cause serious eye damage and a loss of vision.
Scleritis can be treated with oral or topical steroids along withnonsteroidal anti-inflammatory drugs (NSAIDs)like Advil (ibuprofen) that help ease eye pain.
Uveitisrefers to inflammation of the uvea, or the middle layer of the eye between the sclera and the retina. 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.
Choroiditis can eventually damage the blood vessels supplying the retina, sometimes causing the retina to detach from its supporting tissues (retinal detachment). Retinal detachment can lead to blindness unless treated promptly.
CRAO usually happens in people with lupus who also haveantiphospholipid artery syndrome, an autoimmune disorder when the immune system attacks proteins in the blood that regulate blood clotting. CRAO is considered a form ofischemic stroke.
Treatment may involve medications to reduce eye pressure or dissolve blood clots. A procedure called ocular massage may be done shortly after CRAO occurs to gently dislodge the clot and restore blood flow.
Even with treatment, fewer than 20% of people who experience CRAO regain their vision in the affected eye.
Less commonly, people with lupus may developoptic neuritis. Optic neuritis refers to inflammation of the membrane around theoptic nerve, which can lead to tissue death (atrophy). 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.
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Summary
Lupus is an autoimmune disorder that targets and attacks different organs of the body, including the skin, joints, kidneys, blood vessels, and nervous system. When it affects the eyes, it can damage the eyelids, tear glands, cornea, conjunctiva, retina, and optic nerve.
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.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shoughy SS, Tabbara KF.Ocular findings in systemic lupus erythematosus.Saudi J Ophthalmol. 2016;30(2):117–121. doi:10.1016/j.sjopt.2016.02.001National Institute of Arthritis and Musculoskeletal and Skin Diseases.Sjögren’s disease.Penn Medicine.Corneal ulcer.Lupus Foundation of America.How lupus affects the eyes.American Osteopathic College of Dermatology.Discoid lupus erythematosus.Chen XH, Shi JC, Wei J, Chen HH, Mo HY.Increased risk of retinal vasculitis in patients with systemic lupus erythematosus: A nationwide population-based cohort study.Front Med (Lausanne). 2021 Sep;8(1):739883. doi:10.3389/fmed.2021.739883Luboń W, Luboń M, Kotyla P, Mrukwa-Kominek E.Understanding ocular findings and manifestations of systemic lupus erythematosus: Update review of the literature.Int J Mol Sci. 2022 Oct;23(20):12264. doi:10.3390/ijms232012264Yao Y, Wang HX, Liu LW, et al.Acute choroidal involvement in lupus nephritis: A case report and review of literature.World J Clin Cases. 2022 Jul;10(19):6520–6528. doi:10.12998/wjcc.v10.i19.6520Lim Y, Afkhamnejad E, Kavoussi S.Unilateral CRAO as the presenting clinical sign of systemic lupus erythematosus.Am J Opthalmol Case Rep. 2023 Mar;29(1):101810. doi:10.1016/j.ajoc.2023.101810Grory B, Schrag M, Biousse V, et al.Management of central retinal artery occlusion: A scientific statement from the American Heart Association.Stroke. 2021 Mar;52(6). doi:10.1161/STR.0000000000000366Additional ReadingR. R. Sivaraj, O. M. Durrani, A. K. Denniston, P. I. Murray and Caroline Gordon.Ocular Manifestations of Systemic Lupus Erythematosus.pp 1757–1762.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Shoughy SS, Tabbara KF.Ocular findings in systemic lupus erythematosus.Saudi J Ophthalmol. 2016;30(2):117–121. doi:10.1016/j.sjopt.2016.02.001National Institute of Arthritis and Musculoskeletal and Skin Diseases.Sjögren’s disease.Penn Medicine.Corneal ulcer.Lupus Foundation of America.How lupus affects the eyes.American Osteopathic College of Dermatology.Discoid lupus erythematosus.Chen XH, Shi JC, Wei J, Chen HH, Mo HY.Increased risk of retinal vasculitis in patients with systemic lupus erythematosus: A nationwide population-based cohort study.Front Med (Lausanne). 2021 Sep;8(1):739883. doi:10.3389/fmed.2021.739883Luboń W, Luboń M, Kotyla P, Mrukwa-Kominek E.Understanding ocular findings and manifestations of systemic lupus erythematosus: Update review of the literature.Int J Mol Sci. 2022 Oct;23(20):12264. doi:10.3390/ijms232012264Yao Y, Wang HX, Liu LW, et al.Acute choroidal involvement in lupus nephritis: A case report and review of literature.World J Clin Cases. 2022 Jul;10(19):6520–6528. doi:10.12998/wjcc.v10.i19.6520Lim Y, Afkhamnejad E, Kavoussi S.Unilateral CRAO as the presenting clinical sign of systemic lupus erythematosus.Am J Opthalmol Case Rep. 2023 Mar;29(1):101810. doi:10.1016/j.ajoc.2023.101810Grory B, Schrag M, Biousse V, et al.Management of central retinal artery occlusion: A scientific statement from the American Heart Association.Stroke. 2021 Mar;52(6). doi:10.1161/STR.0000000000000366Additional ReadingR. R. Sivaraj, O. M. Durrani, A. K. Denniston, P. I. Murray and Caroline Gordon.Ocular Manifestations of Systemic Lupus Erythematosus.pp 1757–1762.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Shoughy SS, Tabbara KF.Ocular findings in systemic lupus erythematosus.Saudi J Ophthalmol. 2016;30(2):117–121. doi:10.1016/j.sjopt.2016.02.001National Institute of Arthritis and Musculoskeletal and Skin Diseases.Sjögren’s disease.Penn Medicine.Corneal ulcer.Lupus Foundation of America.How lupus affects the eyes.American Osteopathic College of Dermatology.Discoid lupus erythematosus.Chen XH, Shi JC, Wei J, Chen HH, Mo HY.Increased risk of retinal vasculitis in patients with systemic lupus erythematosus: A nationwide population-based cohort study.Front Med (Lausanne). 2021 Sep;8(1):739883. doi:10.3389/fmed.2021.739883Luboń W, Luboń M, Kotyla P, Mrukwa-Kominek E.Understanding ocular findings and manifestations of systemic lupus erythematosus: Update review of the literature.Int J Mol Sci. 2022 Oct;23(20):12264. doi:10.3390/ijms232012264Yao Y, Wang HX, Liu LW, et al.Acute choroidal involvement in lupus nephritis: A case report and review of literature.World J Clin Cases. 2022 Jul;10(19):6520–6528. doi:10.12998/wjcc.v10.i19.6520Lim Y, Afkhamnejad E, Kavoussi S.Unilateral CRAO as the presenting clinical sign of systemic lupus erythematosus.Am J Opthalmol Case Rep. 2023 Mar;29(1):101810. doi:10.1016/j.ajoc.2023.101810Grory B, Schrag M, Biousse V, et al.Management of central retinal artery occlusion: A scientific statement from the American Heart Association.Stroke. 2021 Mar;52(6). doi:10.1161/STR.0000000000000366
Shoughy SS, Tabbara KF.Ocular findings in systemic lupus erythematosus.Saudi J Ophthalmol. 2016;30(2):117–121. doi:10.1016/j.sjopt.2016.02.001
National Institute of Arthritis and Musculoskeletal and Skin Diseases.Sjögren’s disease.
Penn Medicine.Corneal ulcer.
Lupus Foundation of America.How lupus affects the eyes.
American Osteopathic College of Dermatology.Discoid lupus erythematosus.
Chen XH, Shi JC, Wei J, Chen HH, Mo HY.Increased risk of retinal vasculitis in patients with systemic lupus erythematosus: A nationwide population-based cohort study.Front Med (Lausanne). 2021 Sep;8(1):739883. doi:10.3389/fmed.2021.739883
Luboń W, Luboń M, Kotyla P, Mrukwa-Kominek E.Understanding ocular findings and manifestations of systemic lupus erythematosus: Update review of the literature.Int J Mol Sci. 2022 Oct;23(20):12264. doi:10.3390/ijms232012264
Yao Y, Wang HX, Liu LW, et al.Acute choroidal involvement in lupus nephritis: A case report and review of literature.World J Clin Cases. 2022 Jul;10(19):6520–6528. doi:10.12998/wjcc.v10.i19.6520
Lim Y, Afkhamnejad E, Kavoussi S.Unilateral CRAO as the presenting clinical sign of systemic lupus erythematosus.Am J Opthalmol Case Rep. 2023 Mar;29(1):101810. doi:10.1016/j.ajoc.2023.101810
Grory B, Schrag M, Biousse V, et al.Management of central retinal artery occlusion: A scientific statement from the American Heart Association.Stroke. 2021 Mar;52(6). doi:10.1161/STR.0000000000000366
R. R. Sivaraj, O. M. Durrani, A. K. Denniston, P. I. Murray and Caroline Gordon.Ocular Manifestations of Systemic Lupus Erythematosus.pp 1757–1762.
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