Rheumatologic Disorders and Their Ocular Manifestations – Clinical Insights and Therapeutic Approaches

Abstract

Introduction and purpose: Rheumatic disorders, a broad group of conditions primarily affecting the joints, can have significant systemic manifestations that extend beyond musculoskeletal involvement. One such often-overlooked aspect of these diseases is the impact they can have on the eyes. Ocular symptoms are common in many rheumatic diseases and can range from mild irritation to severe sight-threatening complications. This article explores the range of ocular symptoms associated with rheumatic diseases, emphasizing their clinical presentations and the importance of early recognition and treatment.
Materials and methods: A review was conducted in PubMed including publications regarding ocular manifestations of rheumatic diseases. Literature was searched using the following terms: “uveitis in rheumatic disorders”, “spondyloarthropathies”, “systemic lupus erythematosus”, “HLA B27 uveitis” and “treatment of rheumatic diseases”.
Brief description of the state of knowledge: The eyes may be affected either directly through inflammation of various ocular structures or indirectly as part of the systemic manifestations of autoimmune processes. Conditions such as rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome and ankylosing spondylitis often present with ocular involvement including dry eye syndrome, uveitis, scleritis, episcleritis and retinal vasculitis. While some ocular findings may be asymptomatic others can lead to significant visual impairment if not properly managed.
Conclusions: Rheumatic diseases are often associated with a range of ophthalmic complications which can sometimes develop before any other systemic signs of the rheumatic condition appear, making them crucial indicators of potential underlying disease. In many cases, the visual system may be the first to show signs of involvement and recognizing these symptoms early is essential for timely diagnosis and management.