How do autoimmune diseases affect the eyes. What are the common ocular manifestations of autoimmune conditions. Which autoimmune disorders pose the greatest risk to vision health. What are the risk factors for developing autoimmune eye diseases.

Understanding Autoimmune Diseases and Their Ocular Impact

Autoimmune diseases occur when the body’s immune system fails to distinguish between its own cells and foreign invaders, leading to an attack on healthy tissues. This misguided immune response can affect various parts of the body, including the eyes. The ocular manifestations of autoimmune diseases can range from mild discomfort to severe vision impairment, making it crucial to understand their impact on eye health.

Can autoimmune diseases directly target the eyes? Yes, certain autoimmune conditions specifically affect ocular structures. For instance, uveitis is an autoimmune disease that directly targets the uvea, the middle layer of tissue in the eye wall. This condition can cause eye redness, pain, and blurred vision, potentially leading to vision loss if left untreated.

Common Autoimmune Diseases with Ocular Manifestations

Several autoimmune diseases can have significant effects on eye health. Here are some of the most common conditions and their associated ocular manifestations:

• Behcet Disease: A rare condition characterized by ocular lesions, skin lesions, and genital ulcers
• Crohn’s Disease: Can cause episcleritis, a benign inflammation of the episclera
• Diabetes: May lead to lens swelling and retinal blood vessel damage
• Lupus: Can affect various ocular structures, including the sclera and optic nerves
• Multiple Sclerosis: Often associated with optic neuritis
• Psoriasis: Linked to an increased risk of inflammatory eye conditions
• Reactive Arthritis: Commonly accompanied by conjunctivitis
• Rheumatoid Arthritis: Can cause dry eyes and corneal damage
• Sjogren’s Syndrome: Characterized by extremely dry eyes
• Thyroid Diseases: May increase the risk of glaucoma

Behcet Disease: A Rare but Serious Threat to Vision

Behcet Disease is a rare autoimmune condition that deserves special attention due to its potential to cause severe ocular complications. How does Behcet Disease affect the eyes? This condition can impact both the anterior and posterior portions of the eye, leading to various ocular manifestations.

Is Behcet Disease a significant cause of blindness? In some parts of the world, Behcet Disease is indeed a leading cause of blindness. The ocular lesions associated with this condition can severely impair vision if not promptly and properly treated. Early diagnosis and management by an experienced eye specialist are crucial for preserving vision in patients with Behcet Disease.

Ocular Manifestations of Behcet Disease

• Uveitis (inflammation of the uvea)
• Retinal vasculitis
• Optic neuritis
• Scleritis
• Conjunctivitis

Diabetes and Its Impact on Eye Health

Diabetes is a prevalent autoimmune condition that can significantly affect eye health. How does diabetes impact vision? The effects of diabetes on the eyes are primarily related to blood sugar levels and their influence on ocular structures.

Can diabetes cause vision changes? Yes, fluctuations in blood sugar levels can lead to changes in vision. When blood sugar levels shift from low to normal too quickly, the shape of the eye lens can be affected, resulting in blurred vision. This effect is usually temporary and resolves as blood sugar levels stabilize.

Does diabetes pose a long-term risk to eye health? Indeed, chronic high blood sugar levels associated with poorly managed diabetes can cause serious and permanent damage to the eyes. One of the most significant concerns is diabetic retinopathy, a condition where high blood sugar damages the blood vessels in the retina.

Ocular Complications of Diabetes

• Diabetic retinopathy
• Diabetic macular edema
• Increased risk of cataracts
• Glaucoma
• Temporary vision changes due to blood sugar fluctuations

Lupus: A Systemic Autoimmune Disease with Ocular Implications

Lupus is a complex autoimmune disease that can affect multiple organ systems, including the eyes. How does lupus impact ocular health? The inflammation caused by lupus can manifest in various parts of the eye and surrounding structures.

What are the common ocular manifestations of lupus? Lupus can cause inflammation of the white outer layer of the eyeball (scleritis), changes in the skin around the eyelids, and damage to nerves controlling eye movement. These manifestations can lead to discomfort, vision changes, and in severe cases, vision loss.

Ocular Complications Associated with Lupus

• Keratoconjunctivitis sicca (dry eye syndrome)
• Retinal vasculitis
• Optic neuritis
• Scleritis and episcleritis
• Retinal detachment
• Choroidopathy

Multiple Sclerosis and Its Effects on Vision

Multiple sclerosis (MS) is a chronic autoimmune condition that primarily affects the central nervous system, including the optic nerves. How does MS impact vision? One of the most common ocular manifestations of MS is optic neuritis, which is inflammation of the optic nerve.

What are the symptoms of optic neuritis in MS patients? Optic neuritis typically occurs in one eye and can cause various visual disturbances. These may include blurred vision, loss of color vision, and pain with eye movement. In some cases, temporary vision loss may occur.

Visual Symptoms Associated with Multiple Sclerosis

• Optic neuritis
• Diplopia (double vision)
• Nystagmus (involuntary eye movements)
• Internuclear ophthalmoplegia
• Visual field defects

Thyroid Diseases and Their Impact on Ocular Health

Thyroid diseases, including both hyperthyroidism and hypothyroidism, can have significant effects on eye health. How do thyroid disorders affect the eyes? Thyroid diseases can lead to various ocular complications, with one of the most concerning being an increased risk of glaucoma.

Why do thyroid diseases increase the risk of glaucoma? In the case of hyperthyroidism, such as Graves’ disease, tissues can build up around the eye, increasing intraocular pressure. Conversely, in hypothyroid conditions, pressure can build up because the eye is not able to effectively circulate its fluids.

Ocular Manifestations of Thyroid Diseases

• Graves’ ophthalmopathy
• Increased risk of glaucoma
• Dry eye syndrome
• Eyelid retraction
• Proptosis (bulging eyes)
• Diplopia (double vision)

Risk Factors for Autoimmune Eye Diseases

While the exact causes of autoimmune diseases remain unclear, certain factors can increase an individual’s risk of developing these conditions. What are the primary risk factors for autoimmune eye diseases?

Genetic Predisposition

Do autoimmune diseases run in families? Yes, certain autoimmune diseases, such as lupus and multiple sclerosis, have a genetic component. Specific genes can make some individuals more susceptible to developing these conditions. However, it’s important to note that having a genetic predisposition doesn’t guarantee that an individual will develop an autoimmune disease.

Environmental Triggers

Can environmental factors trigger autoimmune diseases? Indeed, various environmental factors can potentially trigger the onset of autoimmune diseases in genetically susceptible individuals. These triggers may include:

• Viral infections
• Bacterial infections
• Certain medications
• Exposure to toxins or chemicals
• Stress
• Hormonal changes

Obesity and Autoimmune Diseases

Is there a link between obesity and autoimmune diseases? Research has shown that obesity can increase the risk of developing certain autoimmune conditions, particularly rheumatoid arthritis and psoriatic arthritis. This association may be due to the increased strain that excess weight places on joints or the pro-inflammatory substances produced by fat tissue.

Smoking and Autoimmune Diseases

Does smoking increase the risk of autoimmune diseases? Yes, numerous studies have linked smoking to an increased risk of developing various autoimmune and immune-mediated diseases. These include:

• Lupus
• Rheumatoid arthritis
• Hyperthyroidism
• Multiple sclerosis

The exact mechanisms by which smoking increases the risk of autoimmune diseases are not fully understood. However, it’s believed that the harmful chemicals in cigarette smoke may trigger or exacerbate autoimmune responses in susceptible individuals.

Diagnosis and Management of Autoimmune Eye Diseases

Early diagnosis and proper management of autoimmune eye diseases are crucial for preserving vision and maintaining overall eye health. How are autoimmune eye diseases diagnosed?

Diagnostic Approaches

• Comprehensive eye examination
• Blood tests to detect specific antibodies
• Imaging studies (e.g., MRI, CT scans)
• Biopsy of affected tissues
• Genetic testing

What are the treatment options for autoimmune eye diseases? The management of autoimmune eye diseases often involves a multidisciplinary approach, combining treatments to control the underlying autoimmune condition and specific therapies to address ocular symptoms.

Treatment Strategies

• Immunosuppressive medications
• Corticosteroids (topical, oral, or intravenous)
• Biological therapies
• Artificial tears and lubricating eye drops
• Surgical interventions (in severe cases)

Is regular eye monitoring important for patients with autoimmune diseases? Absolutely. Regular eye examinations are crucial for individuals with autoimmune diseases, even if they don’t currently have ocular symptoms. Early detection of eye complications can lead to more effective treatment and better outcomes.

Emerging Research and Future Directions

The field of autoimmune eye diseases is rapidly evolving, with ongoing research aimed at improving diagnosis, treatment, and prevention strategies. What are some promising areas of research in autoimmune eye diseases?

Cutting-edge Research Areas

• Gene therapy for inherited autoimmune eye diseases
• Targeted biological therapies
• Stem cell treatments for ocular tissue regeneration
• Nanotechnology-based drug delivery systems
• Artificial intelligence for early detection and prognosis

Will personalized medicine play a role in treating autoimmune eye diseases? The future of autoimmune eye disease management is likely to involve more personalized approaches. By analyzing an individual’s genetic profile, immune system characteristics, and environmental factors, healthcare providers may be able to tailor treatments more effectively and potentially prevent the onset of autoimmune eye diseases in high-risk individuals.

Living with Autoimmune Eye Diseases: Coping Strategies and Support

Coping with an autoimmune eye disease can be challenging, but there are strategies that can help improve quality of life and maintain eye health. What can individuals with autoimmune eye diseases do to manage their condition effectively?

Self-care Strategies

• Adhere to prescribed treatment regimens
• Practice good eye hygiene
• Protect eyes from UV radiation
• Maintain a healthy lifestyle (balanced diet, regular exercise, stress management)
• Quit smoking and limit alcohol consumption
• Use adaptive devices and technologies as needed

Is psychological support important for individuals with autoimmune eye diseases? Yes, the emotional impact of living with a chronic condition that affects vision can be significant. Many individuals with autoimmune eye diseases benefit from psychological support, whether through professional counseling, support groups, or peer networks.

Support Resources

• Patient advocacy organizations
• Online support communities
• Low vision rehabilitation services
• Occupational therapy
• Mental health professionals specializing in chronic illness

By understanding the ocular manifestations of autoimmune diseases, recognizing risk factors, and implementing appropriate management strategies, individuals can better navigate the challenges of autoimmune eye conditions. As research continues to advance, there is hope for improved treatments and outcomes for those affected by these complex disorders.

Autoimmune Diseases That Affect the Eyes

An autoimmune disease occurs when the natural defense system of a body is not able to differentiate its own cells from foreign cells. As a result, the immune system mistakenly attacks normal cells. Nearly every part of the body – including the eyes – can take the brunt of autoimmune diseases.

In this article, a reputable eye clinic takes a closer look at some of the autoimmune diseases that can heavily affect the eyes, the common symptoms of these conditions and their risk factors.

Autoimmune Diseases That Are Linked to Vision Health

There are more than 80 types of autoimmune diseases that affect a wide range of body parts, from nerves and joints to eyes. Some autoimmune diseases that typically affect the eyes are:

Behcet Disease
This rare autoimmune disease characterized by ocular lesions, skin lesions and genital ulcers is a leading case of blindness in some parts of the world. It can affect the anterior and posterior portions of the eye.

Crohn’s Disease
This type of inflammatory bowel disease causes swelling of the tissues in the digestive tract. The main eye-related problem that can occur with Crohn’s disease is episcleritis, a common and benign cause of red eye.

Diabetes
A potential effect of diabetes is swelling of the eye lens. If blood sugar levels change from low to normal too quickly, the shape of the eye lens can be affected, leading to blurred vision. High blood sugar can also damage the blood vessels in the retina, the light-sensitive part of the eye.

Lupus
Inflammation caused by lupus can affect many systems of the body, including the skin, brain, heart and lungs. The effects of lupus in and around the eyes include inflammation of the white outer layer of the eyeball, changes in the skin around the eyelids and damage to nerves controlling eye movement.

Multiple Sclerosis
This is a lifelong condition that can affect the brain and spinal cord. Optic neuritis or inflammation of the optic nerve is a common symptom of this disease. It usually occurs in one eye and can cause blurred vision, loss of color vision and pain with eye movement.

Psoriasis
A common chronic skin disease, psoriasis causes rashes with itchy, scaly patches all over the body, most typically on the scalp, knees and elbows. Some types of psoriasis are linked to a heightened risk of developing inflammatory eye conditions, such as conjunctivitis or inflammation of the eyelid.

Reactive Arthritis
Formerly known as Reiter’s syndrome, reactive arthritis is a condition that causes redness and swelling in various joints of the body. Many people with this condition also develop conjunctivitis.

Rheumatoid Arthritis
This is an autoimmune and inflammatory disease that causes painful swelling in affected parts of the body. Its most common eye-related symptom is dryness of the sclera, which, if left untreated, can cause damage to the cornea, the clear surface that helps the eye focus.

Sjogren’s Syndrome
A disorder of the immune system, Sjogren’s syndrome is identified by its two most common symptoms: dry eyes and a dry mouth. Because of the decrease in tear production, the eyes may feel extremely dry, itchy or burning.

Thyroid Diseases
This is a group of autoimmune diseases that result in high or low thyroid function. It increases the risk of developing glaucoma, a condition that causes high pressure inside the eye. With Graves’ disease, for instance, tissues build up around the eye and increase pressure. With low-thyroid disorders, on the other hand, pressure builds up because the eye is not able to effectively circulate its fluids.

Uveitis
This is an autoimmune disease that directly affects the middle layer of tissue in the eye wall called uvea. Its common symptoms include eye redness, pain and blurred vision. It can affect one or both eyes and can cause vision loss if left untreated by an eye specialist.

Risk Factors of Autoimmune Diseases

While the exact cause of autoimmune diseases is unknown, some people are more likely to develop an autoimmune disease than others. Risk factors that increase the chances of developing autoimmune diseases include:

Genetics: Certain autoimmune diseases like lupus and multiple sclerosis do tend to run in families, meaning that certain genes make some people more likely to develop them. Viruses, chemicals and other things in the environment can trigger an autoimmune disease if the body already possesses the genes for it.

Weight: Obesity increases the risk of developing rheumatoid arthritis or psoriatic arthritis. This could be due to heavier weight putting significant strain on the joints or fat tissues producing substances that encourage inflammation.

Smoking: Research has also linked smoking to the development of several immune and autoimmune diseases, such as lupus, rheumatoid arthritis, hyperthyroidism and multiple sclerosis. Smoking has wide-reaching effects on the immune system, including increasing inflammation levels and allergic conditions.

Medications: Some blood pressure medications or antibiotics can trigger drug-induced lupus, a generally milder version of the idiopathic disorder. Specific medications used to lower cholesterol can also trigger statin-induced myopathy, a rare autoimmune disease causing muscle weakness.

Medicines That Can Help Treat Eye Symptoms of Autoimmune Diseases

Fortunately, there are over-the-counter medicines that can help alleviate the eye-related symptoms of autoimmune diseases. These include artificial tears, lubricating gels and ointments, all of which can help with dry eyes. These medicines bring moisture back to the surface of the eye. Other inflammatory conditions are sometimes treated with oral non-steroidal anti-inflammatory drugs that are available over the counter. Patients who do not respond to oral medications should be referred to an ophthalmologist for possible treatment with immunosuppressive medications.

The Importance of Getting Regular Eye Examinations

Aside from eating a balanced diet and leading a healthy lifestyle, one of the most critical steps to preserve eyesight is to regularly attend appointments with an ophthalmologist. According to the American Academy of Ophthalmology, all adults should undergo eye screening at age 40 to maintain healthy vision, especially if they have not seen an eye specialist previously. Generally, however, adults aged 18 to 60 should get a comprehensive eye exam at least every two years.

If you happen to be affected by an autoimmune disease:

• You should not wait until you are 40 years old to get a vision health screening. If you have not been to an ophthalmologist in the past year, it will be for your own benefit to see one now.

• Make sure you talk to your doctor about how often you need a vision screening. If you are experiencing symptoms related to vision health issues, then you will definitely need to get screened more frequently. Some patients get screened as often as every six months, but this is for severe cases.

• It is also important to get regular eye examinations if you are taking medications for autoimmune disease treatment, such as hydroxychloroquine, which can cause ocular toxicity to various parts of the eye. Other medications for autoimmune diseases that can have negative effects on vision health include corticosteroids, which can increase the risk of cataracts and glaucoma when used long-term.

Most autoimmune diseases can be managed with medication, although serious eye damage and, in some cases, blindness can happen if they are not treated. An eye doctor and an autoimmune specialist should work closely together to effectively treat eye symptoms that occur with autoimmune diseases.

Ocular Autoimmune Disease: An Introduction – Uveitis.org

The immune system, ordinarily in the “business” of protecting us from harm, generally protecting us from germs and cancer cells, can become deranged, disregulated, with the result being an immune attack on part of our own body. This state of affairs is termed autoimmunity, or immune attack against self.

A number of autoimmune diseases exist, the most famous, perhaps being rheumatoid arthritis. In rheumatoid arthritis the white blood cells of the immune system become disregulated or “confused” and begin to attack the individual’s joints. A number of autoimmune diseases exist in which the eye or various parts of the eye may be attacked by the white blood cells. Often the autoimmune disease is systemic, i.e., a variety of organs throughout the body system are being attacked. Examples of such diseases include rheumatoid arthritis, systemic lupus erythematosus, polyarteritis nodosa, relapsing polychondritis,
Granulomatosis with Polyangiitis (formerly called Wegener’s), scleroderma, Behcet’s disease, Reactive Arthritis (formerly called Reiter’s syndrome), inflammatory bowel disease (ulcerative colitis and Crohn’s disease) and ankylosing spondylitis.

The eye may be affected as a target of immune inflammatory attack in any of these diseases. The eye may, however, in certain instances be the specific and only target affected by certain autoimmune diseases. Some such diseases include ocular cicatricial pemphigoid, Mooren’s corneal ulcer, and various forms of uveitis.

Regardless of the form of autoimmunity, any autoimmune disease affecting the eye will require systemic (e.g., oral as opposed to local, topical, ocular) therapy; the components of the immune system reside not in the eye, but rather are systemic, and therefore, regulation of those components will require systemic therapy. Such therapy is typically designed to suppress the overly aggressive immune system, allowing the body to eventually re-regulate itself, with the result often being that after the patient has been kept on systemic medications to suppress the inappropriate immune response for a finite length of time (for example, one year), medication can then be tapered and stopped without recurrence of the autoimmune attack. Sometimes resumption of the attack does occur, in which case the patient must be re-treated.

Ophthalmologists in general are not accustomed to treating patients systemically, and in particular, are not trained to use immunosuppressive drugs in order to control autoimmune phenomena. Many ophthalmologists, however, realize that such treatment is appropriate and indicated for the aforementioned problems, and therefore, the ophthalmologist will collaborate with a chemotherapist who will take responsibility for monitoring and managing the patient’s systemic therapy, while the ophthalmologist monitors the progress of the ocular manifestation of the autoimmune attack (inflammation).

In most instances, this collaboration between ophthalmologist and chemotherapist works very well, and our experience in helping ophthalmologists to establish such collaborations and to effectively treat patients with autoimmune diseases affecting the eye has been gratifyingly successful in almost every country around the globe. This represents a major change from years ago, when many patients still lost all use of one or both eyes from the ravages of improperly treated autoimmune disease affecting the eye.

The hope for the future is for more selective treatment strategies for specific autoimmune diseases, for example, cloning the causative gene for that protein, which we could use as a strategy to re-regulate patients’ immune systems to that protein without the use of immunosuppressant drugs. It is entirely possible that similar strategies can be applied effectively in all autoimmune ocular diseases and studies are underway.

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C. Stephen Foster, M.D.

Features of ophthalmic pathology in autoimmune diseases | Lukashenko

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Eye and autoimmune rheumatic diseases

• 1
  Rheumatoid arthritis

• 2
  Systemic lupus erythematosus

• 3
  scleroderma

• 4
  Hashimoto’s thyroiditis

• 5
  Seronegative spondyloarthropathies

• 6
  Eye damage in rheumatic diseases

• 7
  Sjögren’s syndrome

• 8
  cicatricial pemphigoid

• 9
  Steven-Johnson Syndrome

• 10
  Graft-versus-host disease

Most rheumatic diseases are immunological in nature, attacking one’s own tissues, this is what we know as an autoimmune reaction, and it can affect various parts of the body, including the eyes, so it is important to know this connection between rheumatic diseases and eye damage.

In this article we will review the most common rheumatic and autoimmune processes that can affect the eyes, as well as the form of manifestation at the ocular level:

Rheumatoid arthritis

varying degrees of deformation and functional disability. Sometimes its behavior is extra-articular in nature and can affect various organs and systems, such as the eyes, lungs and pleura, heart and pericardium, skin or blood vessels. Although the cause of the disease is unknown, autoimmunity plays an important role in the chronic course of the disease.

At the eye level of the crisis, uveitis (inflammation of the middle membrane of the eye: iritis, when located anteriorly and choroiditis, when it affects the back region). Another form of manifestation is episcleritis, scleritis or dry eye syndrome due to damage to the lacrimal glands and the ocular surface (cornea and conjunctiva).

Articular deformity of the hand in rheumatoid arthritis

Systemic lupus erythematosus

This is a chronic autoimmune disease affecting the connective tissue, characterized by inflammation and tissue damage mediated by the immune system, in particular due to the binding of antibodies to body cells and the deposition of antigen-antibody complexes. It can affect any part of the body, although the most common sites are the reproductive system, joints, skin, lungs, blood vessels, kidneys, liver (the first organ it usually affects), and the nervous system. . The course of the disease is unpredictable, periods of crises alternate with remissions. It is nine times more common in women than in men. The first manifestations of the disease are more often observed between the ages of 15 and 44 years.

Erythema of the wings of a butterfly in systemic lupus erythematosus. Erythema and inflammation of the skin in systemic lupus erythematosus.

Eye involvement can also be in the form of uveitis scleritis, conjunctivitis o Dry eye syndrome.

Scleroderma

Scleroderma (“roughening of the skin”), also called progressive systemic sclerosis and CREST syndrome, is a diffuse connective tissue disease characterized by changes in the skin, blood vessels, skeletal muscles, and internal organs. The causes of this disease are unknown.

Scleroderma causes thickening and hypertrophy of the connective tissue, increasing its volume. It can also cause swelling or pain in muscles and joints.

Hands in claws due to sclerosis of the skin in scleroderma

At the eye level, they often appear conjunctivitis, non-infectious diseases that are difficult to diagnose, as well as ocular dryness and inflammation of the internal structures of the eye: retinal vasculitis and uveitis.

Hashimoto’s thyroiditis

This is an autoimmune disease (due to antithyroid autoantibodies) that causes inflammation of the thyroid gland. It is a common cause of primary subclinical hypothyroidism due to thyroiditis, goiter, or severe hypothyroidism. The clinical picture is the same as in any condition of hypothyroidism, so the treatment is thyroid hormone replacement therapy. The disease is more common in women than in men (in a ratio of 14:1), usually manifests or is detected between the ages of 20 and 30 years.

Enlargement of the thyroid gland in Hashimota thyroiditis

At the ocular level, non-infectious conjunctivitis and dryness syndrome due to hyposecretion of lacrimal fluid and drying of the ocular surface are common, since these patients usually have altered, less frequent and incomplete blinking.

Seronegative spondyloarthropathies

Spondyloarthropathies are autoimmune inflammatory diseases of the spine, spine and especially the sacroiliac joints. The term seronegative spondyloarthropathy comes from the fact that a blood test or serological test called rheumatic factor is negative. This group includes diseases such as ankylosing spondylitis, psoriatic arthropathy, Reiter’s syndrome (or reactive arthritis), Crohn’s disease, uveitis, etc. From 60% to 90% of people with this disease have the HLA-B27 antigen, but only 8% of the population have this antigen.

Inflammation and pain in the lumbosacral spine in seronegative spondyloarthropathies Mucocutaneous manifestations and conjunctivitis Sx. Reiter

These patients commonly present with multiple ocular changes, especially uveitis, scleritis, conjunctivitis, and even corneal involvement. keratitis y ulcers that can reduce vision in a very important way.

Eye affection in rheumatic diseases

All these diseases have a great influence at eye level. They cause inflammatory processes that can affect the most superficial layers of the eye, such as simple conjunctivitis, or deeper layers, causing episcleritis, scleritis, uveitis, and vasculitis in the vessels of the eye. retina. It is important to know this connection between rheumatic and ocular diseases, as a correct diagnosis of ocular manifestations can help to identify a systemic process and vice versa. In people suffering from a rheumatic process involving the eyes, the latter will not resolve unless the former is properly treated. This is why it is essential that an ophthalmologist be first and foremost a physician and thus work alongside other specialists. At the level of the ocular surface, it is worth mentioning Sjögren’s syndrome, a frequent pathology in immunological diseases.

Sjögren’s syndrome

It can be primary or secondary, in primary forms it usually has an idiopathic cause and appears in women between the 4th. and 5th. decade of life. In secondary forms, it is associated with autoimmune diseases: rheumatoid arthritis, lupus erythematosus, scleroderma, Hashimoto’s thyroiditis, etc. The age of manifestation varies greatly, more often in women.

The eye condition is characterized by the development of dryness and atrophy of the conjunctiva and cornea, causing this condition: Keratoconjunctivitis dry. What causes a feeling of sand, burning, itching, hyperemia, decreased tearing, which leads to the accumulation of thick stripes in the inner corner of the eye, photosensitivity and blurred vision. Secondary infections, ulcers and iridocyclitis.

Leukoma and neovascularization of the cornea in the advanced stages of Sjögren’s syndrome

cicatricial pemphigoid

This is an idiopathic, chronic and progressive process, more common in older people and women. It is characterized by the presence of recurrent subepithelial pots and vesicles on the skin and mucous membranes with a tendency to scarring.

In the eyes, papillary conjunctivitis may debut and later form subconjunctival vessels, which, when opened, leave ulcers and pseudomembranes. The most dangerous eye complications are: severe dryness of the eyes, conjunctival adhesions, palpebral adhesions, cicatricial eversion of the eyelid (eversion of the eyelid outwards).

Simblepharon in cicatricial pemphigoid

Steven-Johnson syndrome

Disease of the mucous membranes with the formation of amphipods and vesicles, acute and severe course, usually self-limiting. It is more common in healthy young people and men.

Causes that can provoke the disease are hypersensitivity reactions to drugs, infections caused by Mycoplasma Pneumoniae and herpes simplex virus.

At the ocular level, it may present with papillary conjunctivitis, which may heal without sequelae or cause complications such as: keratinization and fibrosis of the conjunctiva, metaplastic inlays, obstruction of the lacrimal ducts, ectropion (eyelid eversion outwards) and inversion cicatricial (eversion of the eyelids inward).

Blefaritis associated with conjunctivitis with purulent discharge in Stevens-Johnson Sx

Graft-versus-host disease

In GVHD, the immune response originates from the donor tissue (usually bone marrow) and is produced against the recipient, who is usually immunosuppressed.