How do autoimmune diseases affect vision. What are the common eye conditions associated with autoimmune disorders. Which parts of the eye can be impacted by autoimmune diseases. How can autoimmune-related eye symptoms be diagnosed and treated.

The Link Between Autoimmune Diseases and Eye Health

Autoimmune diseases are a group of disorders in which the body’s immune system mistakenly attacks its own tissues. These conditions can affect various organs and systems, including the eyes. Understanding the ocular manifestations of autoimmune diseases is crucial for early detection and proper management of these conditions.

There are over 100 known autoimmune diseases, including rheumatoid arthritis, lupus, Sjögren’s syndrome, Graves’ disease, Crohn’s disease, celiac disease, and Lyme disease. Many of these conditions can have significant impacts on eye health and vision.

How does the immune system affect the eyes in autoimmune diseases?

In autoimmune diseases, the immune system becomes confused and starts attacking healthy tissues in the body. The eyes are often one of the first areas to be noticeably affected. This can lead to inflammation, damage, and various eye-related symptoms.

Common Ocular Manifestations of Autoimmune Diseases

Autoimmune diseases can affect different parts of the eye, leading to various conditions and symptoms. Here are some of the most common ocular manifestations:

Dry Eye Syndrome (Keratoconjunctivitis Sicca)

Dry eye is a frequent complaint among individuals with autoimmune diseases. This condition, also known as keratoconjunctivitis sicca, occurs when the eyes don’t produce enough tears or when the tears evaporate too quickly.

• Symptoms: Burning sensation, itching, redness, and a gritty feeling in the eyes
• Associated autoimmune diseases: Sjögren’s syndrome, rheumatoid arthritis, lupus

Uveitis

Uveitis refers to inflammation of the uvea, the middle layer of the eye. There are different types of uveitis, depending on which part of the uvea is affected:

1. Anterior uveitis: Inflammation of the iris
2. Peripheral uveitis (Pars Planitis): Inflammation of the tissue next to the iris
3. Posterior uveitis: Inflammation of the choroid

Symptoms of uveitis may include eye redness, light sensitivity, blurred vision, and dark floating spots in the vision. Autoimmune diseases commonly associated with uveitis include rheumatoid arthritis, ankylosing spondylitis, and Crohn’s disease.

Scleritis

Scleritis is an inflammation of the sclera, the white outer layer of the eye. This condition can be extremely painful and may lead to vision loss if left untreated.

• Symptoms: Severe eye pain, redness, light sensitivity, and blurred vision
• Associated autoimmune diseases: Rheumatoid arthritis, lupus, granulomatosis with polyangiitis

Keratitis

Keratitis is an inflammation of the cornea, the clear front surface of the eye. In some cases, it can lead to the formation of corneal ulcers.

• Symptoms: Eye pain, redness, blurred vision, and light sensitivity
• Associated autoimmune diseases: Rheumatoid arthritis, lupus, Sjögren’s syndrome

Optic Neuritis

Optic neuritis is an inflammation of the optic nerve, which transmits visual information from the eye to the brain.

• Symptoms: Pain with eye movement, blurred vision, difficulty seeing at night, and color vision changes
• Associated autoimmune diseases: Multiple sclerosis, lupus, neuromyelitis optica

Episcleritis

Episcleritis is an inflammation of the episclera, the thin layer of tissue between the conjunctiva and the sclera. Unlike scleritis, episcleritis is usually benign and not painful.

• Symptoms: Mild redness of the white part of the eye
• Associated autoimmune diseases: Rheumatoid arthritis, Crohn’s disease, ulcerative colitis, lupus

Exophthalmos

Exophthalmos, also known as proptosis, is a condition where the eyes protrude or bulge outward. It is most commonly associated with Graves’ disease, an autoimmune disorder affecting the thyroid gland.

• Symptoms: Bulging eyes, double vision, eye pressure or pain
• Associated autoimmune disease: Graves’ disease

Diagnosing Autoimmune-Related Eye Conditions

Diagnosing eye conditions related to autoimmune diseases often requires a collaborative approach between eye care professionals and other medical specialists. The process may involve:

1. Comprehensive eye examination
2. Medical history review
3. Blood tests to check for markers of autoimmune diseases
4. Imaging studies (e.g., MRI, CT scan)
5. Referrals to rheumatologists or other specialists

Can eye symptoms be the first sign of an autoimmune disease?

Yes, in many cases, eye symptoms can be the first noticeable sign of an underlying autoimmune disease. This is why regular eye exams and prompt attention to any changes in vision or eye health are crucial for early detection and management of these conditions.

Treatment Approaches for Autoimmune-Related Eye Conditions

Treatment for eye conditions related to autoimmune diseases typically involves a combination of approaches aimed at managing both the underlying autoimmune disorder and the specific eye symptoms. Some common treatment strategies include:

• Immunosuppressive medications to control the autoimmune response
• Corticosteroids to reduce inflammation
• Artificial tears and other lubricating eye drops for dry eye symptoms
• Biological therapies targeting specific inflammatory pathways
• Surgery in severe cases (e.g., corneal transplantation)

How effective are treatments for autoimmune-related eye conditions?

The effectiveness of treatments can vary depending on the specific condition and individual patient factors. Many patients experience significant improvement with proper management, but some may require ongoing treatment to maintain eye health and prevent complications.

Lifestyle Modifications and Self-Care for Autoimmune Eye Conditions

In addition to medical treatments, certain lifestyle modifications and self-care practices can help manage autoimmune-related eye conditions:

• Maintaining good overall health through a balanced diet and regular exercise
• Avoiding triggers that may exacerbate symptoms (e.g., smoke, allergens)
• Using protective eyewear when outdoors or in dusty environments
• Practicing good eye hygiene and following a proper eyelid cleaning routine
• Managing stress through relaxation techniques or mindfulness practices
• Getting adequate sleep to support overall immune function

How can patients best manage their eye health with an autoimmune disease?

Patients with autoimmune diseases should work closely with their healthcare team, including eye care professionals, to develop a comprehensive management plan. Regular check-ups, adherence to prescribed treatments, and prompt reporting of any new or worsening symptoms are key to maintaining optimal eye health.

The Importance of Early Detection and Regular Monitoring

Early detection and regular monitoring of autoimmune-related eye conditions are crucial for preventing vision loss and other complications. Patients with known autoimmune diseases should be particularly vigilant about their eye health and schedule regular comprehensive eye exams.

How often should individuals with autoimmune diseases have their eyes examined?

The frequency of eye exams may vary depending on the specific autoimmune disease and the presence of any eye-related symptoms. In general, annual comprehensive eye exams are recommended for individuals with autoimmune diseases, but some may require more frequent monitoring based on their individual circumstances.

Emerging Research and Future Directions

The field of ocular immunology is rapidly evolving, with ongoing research into new treatment modalities and diagnostic techniques for autoimmune-related eye conditions. Some areas of current interest include:

• Development of more targeted biological therapies
• Advancements in gene therapy for inherited autoimmune eye disorders
• Improved imaging techniques for early detection of eye inflammation
• Investigation of the role of the gut microbiome in autoimmune eye diseases
• Exploration of regenerative medicine approaches for treating ocular surface disorders

What are the most promising areas of research in autoimmune eye diseases?

Some of the most promising areas of research include the development of more targeted immunomodulatory therapies with fewer side effects, as well as advancements in personalized medicine approaches that tailor treatments to individual patients based on their genetic and immunological profiles.

Patient Support and Resources

Living with an autoimmune disease that affects the eyes can be challenging, but numerous resources and support networks are available to help patients and their families. Some valuable resources include:

• American Autoimmune Related Diseases Association (AARDA)
• The Ocular Immunology and Uveitis Foundation
• National Eye Institute (NEI)
• Sjögren’s Syndrome Foundation
• Lupus Foundation of America
• Arthritis Foundation

How can patients find support for managing autoimmune-related eye conditions?

Patients can seek support through various channels, including patient advocacy groups, online forums, local support groups, and educational resources provided by reputable health organizations. Additionally, many healthcare providers can offer referrals to mental health professionals or social workers who specialize in helping patients cope with chronic health conditions.

Understanding the ocular manifestations of autoimmune diseases is essential for both patients and healthcare providers. By recognizing the signs and symptoms of these conditions, seeking prompt medical attention, and following appropriate treatment plans, individuals with autoimmune diseases can better protect their vision and maintain overall eye health. As research in this field continues to advance, new and improved treatment options offer hope for better outcomes and improved quality of life for those affected by autoimmune-related eye conditions.

Autoimmune Disease and Vision – All About Eyes

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.

Autoimmune Disease Explained

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. Be sure to click on the various links to see in-depth research and explanations. Here are some additional resources:

• American Autoimmune Related Diseases Association
• American Optometric Association
• American Family Physician
• The Ocular Immunology and Uveitis Foundation
• Sjogren’s Syndrome

anterior uveitis autoimmune diseases Episcleritis exophthalmos Graves’ disease keratitis keratoconjunctivitis sicca optic neuritis peripheral uveitis scleritis

Uveitis – Causes – NHS

Uveitis happens when the eye becomes red and swollen (inflamed).

Inflammation is the body’s response to illness or infection.

Most cases of uveitis are linked to a problem with the immune system (the body’s defence against infection and illness).

Rarely, uveitis may happen without the eye becoming red or swollen.

Immune system problems

Uveitis often happens in people who have an autoimmune condition. This is where the immune system mistakenly attacks healthy tissue.

Autoimmune conditions known to cause uveitis include:

• ankylosing spondylitis – a condition where the spine and other areas of the body become inflamed
• reactive arthritis – a condition that causes inflammation in various areas of the body
• conditions that cause bowel inflammation – such as Crohn’s disease and ulcerative colitis
• psoriasis – a skin condition
• psoriatic arthritis – a type of arthritis that develops in some people with psoriasis
• multiple sclerosis – a condition mainly affecting the nerves
• Behçet’s disease – a rare condition that causes mouth ulcers and genital ulcers
• sarcoidosis – a rare inflammatory condition that affects the lungs, skin and eyes
• juvenile idiopathic arthritis– a type of arthritis that affects children

Infection

Uveitis can also be caused by an infection, such as:

• toxoplasmosis – an infection caused by a parasite
• herpes simplex virus – the virus responsible for cold sores
• varicella-zoster virus – the virus that causes chickenpox and shingles
• cytomegalovirus – a common infection that does not usually cause any noticeable symptoms, but can cause sight-threatening uveitis in people with a lowered immune system
• tuberculosis
• HIV and syphilis are rare causes

Other causes

Uveitis can also be caused by:

• trauma or injury to the eyes, or eye surgery
• some types of cancers, such as Non-Hodgkin lymphoma, although this is a very rare cause of uveitis

Sometimes, a specific cause of uveitis cannot be identified.

Gene HLA-B27

Although uveitis is not passed down through families, a gene known as HLA-B27 has been linked to an increased risk of developing uveitis at the front of the eye (anterior uveitis).

About half of all people with anterior uveitis have the HLA-B27 gene. The gene has been found in people with certain autoimmune conditions, including ankylosing spondylitis and ulcerative colitis.

Page last reviewed: 03 January 2020
Next review due: 03 January 2023

Features of ophthalmic pathology in autoimmune diseases | Lukashenko

1. Basantsova N.Yu., Zinchenko Yu.S., Starshinova A.A., Yablonsky P.K. Features of the diagnosis of neuropathy of small fibers in various diseases (literature review) // Pediatrician, 2018. V. 9, No. 6. P. 101-110.

2. Vizel A.A. Sarcoidosis: monograph. M.: Atmosfera, 2010. 416 p.

3. Godzenko A.A. Prospects for the treatment of uveitis in rheumatic diseases // Modern Rheumatology, 2011. V. 2, No. 37. C. 42.

4. Zaitseva N.S., Katsnelson L.A. Uveitis. Moscow: Medicine, 1984. 318 p.

5. Kansky D. Clinical ophthalmology: a systematic approach. Per. from English. M.: Logosfera, 2006. P. 744.

6. Plekhanov A.N., Fomina A.S., Sverkunova O.P., Ivanova Yu.V. Autoimmune uveitis. Review // Ophthalmology, 2019. V. 16, No. 1. P. 5-11.

7. Polunin G.S., Safonova T.N., Polunina E.G. Features of the clinical course of various forms of dry eye syndrome – the basis for the development of adequate methods of treatment // Bulletin of the ophthalmologist, 2006. V. 102, No. 5. P. 17-20.

8. Roit A, Brostoff J, Meil ​​D. Immunology. Per. from English. M.: Mir, 2000. 208 p.

9. Ustinova E.I. Endogenous uveitis (selected lectures for ophthalmologists). St. Petersburg: Eco-Vector, 2017. 204 p.

10. Shishkin A.N. Diffuse diseases of connective tissue / Systemic pathology of connective tissue. Ruk. For doctors / Ed. Yu.I. Stroeva, L.P. Churilova. St. Petersburg: Elbi-SPb, 2014. S. 282-313.

11. Akiki R.K., Statler B., Greenberg P.B., Janigian R.H. Unilateral birdshot chorioretinopathy in an elderly patient. R.I. Med. J., 2019Vol. 102, no. 1, pp. 60-61.

12. Alhatem A., Cavalcanti B., Hamrah P. In vivo confocal microscopy in dry eye disease and related conditions. Semin. Ophthalmol., 2012, Vol. 27, no. 5-6, pp. 138-148.

13. Avichezer D., Chan C.C., Silver P.B., Wiggert B., Caspi R.R. Residues 1-20 of IRBP and whole IRBP elicit different uveitogenic and immunological responses in interferon gamma deficient mice. Exp. Eye Res, 2000, Vol. 71, no. 2, rr. 111-118.

14. Becker M.D., Adamus G., Davey M.D., Rosenbaum J.T. The role of T-cells in autoimmune uveitis. Ocul. Immunol. Inflam., 2000, Vol. 8, no. 2, rr. 93-100.

15. BENITEZ-DEL-CASTILLO J.M., Acosta M.C., Wassfi M.A., Díaz-Valle D., Gegóndez J.A., Fernandez C., Garcíasánchez J. Relation Between Corneal Innervation with Con Focal Microscopy and Corneal Sensitivity with NonContact Esthesiometry in Pathents with Dry eye. Invest. Ophthalmol. Vis. Sc., 2007, Vol. 48, no. 1, rr. 173-181.

16. Bose T., Diedrichs-Möhring M., Wildner G. Dry eye disease and uveitis: A closer look at immune mechanisms in animal models of two ocular autoimmune diseases. J. Autoimmun. Rev., 2016, no. 15 (12), pp. 1181-1192.

17. Boulton A.J., Malik R.A., Arezzo J.C., Sosenko J.M. Diabetic somatic neuropathies. Diabetes Care, 2004, Vol. 27, no. 6, rr. 1458-1486.

18. Coulon C., Kodjikian L., Rochepeau C., Perard L., Jardel S., Burillon C., Broussolle C., Jamilloux Y., Seve P. Ethnicity and association with ocular, systemic manifestations and prognosis in 194 patients with sarcoid uveitis. Graefes. Arch. Clin. Exp. Ophthalmol., 2019, Vol. 257, no. 11, pp. 2495-2503.

19. Cruzat A., Qazi Y., Hamrah P. In vivo confocal microscopy of corneal nerves in health and disease. Ocul. Surf., 2017, Vol. 15, no. 1, pp. 15-47.

20. Davatchi F. Behcet’s disease. J. Int. Rheum. Dis., 2014, Vol. 17, no. 4, rr. 355-357.

21. Davatchi F., Shahram F., Chams-Davatchi C., Shams H., Nadji A., Akhlaghi M., Faezi T., Ghodsi Z., Faridar A., ​​Ashofteh F., Abdollahi B.S. Behcet’s disease: from east to west. Clin. Rheumatol., 2010, Vol. 29, no. 8, pp. 823-833.

22. Direskeneli H. Behçet’s disease: infectious aetiology, new autoantigens, and HLA-B51. Ann. Rheum. Dis., 2001, Vol. 60, no. 11, pp. 996-1002.

23. Kernel A., Dedorsson I., Johansson B., Wickstrom C.P., Ludvigsson J., Tuvemo T., Neidemd J., Sjostrom K., Malmgreen K., Kanulf P., Mellvig Gjotterberg M., Sule J ., Persson L.A., Larsson L.I., Aman J., Dahlquist. Prevalence of diabetic retinopathy in children and adolescens with IDDM. A population-based multicentre study. Diabetologia, 1997, Vol. 40, no. 3, pp. 307-310.

24. Malik R.A, Kallinikos P., Abbott C.A., van Schie C.H.M., Morgan P., Efron N., Boulton A.J.M. Corneal confocal microscopy: a noninvasive surrogate of nerve fiber damage and repair in diabetic patients. Diabetology, 2003, Vol. 46, pp. 683-688.

25. Malik R.A., Veves A., Walker D., Siddique I., Lye R.H., Schady W., Boulton A.J. Sural nerve fiber pathology in diabetic patients with mild neuropathy: relationship to pain, quantitative sensory testing and peripheral nerve electrophysiology. Acta Neuropathol., 2001, Vol. 101, pp. 367-374.

26. Messmer E.M., Schmid-Tannwald C., Zapp D., Kampik A. In vivo confocal microscopy of corneal small fiber damage in diabetes mellitus. Graefs Arch. Clin. Exp. Ophthalmol., 2010, Vol. 248, no. 9, rr. 1307-1312.

27. Messmer E.M. The pathophysiology, diagnosis, and treatment of dry eye disease. Dtsch Arztebl. Int., 2015, Vol. 112, no. 5, pp. 71-81.

28. Morgan J.P., Robins R.A., Dua H.S., Tighe P.J. S antigen specific effector T cell activation detected by cytokine flow cytometry. Br. J. Ophthalmol., 2002, Vol. 86, no. 5, pp. 517-520.

29. No authors listed. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop. Ocul. Surf., 2007, Vol. 5, no. 2, rr. 75-92.

30. Pasadhika S., Rosenbaum J.T. Ocular Sarcoidosis. Clin. Chest. Med., 2015, Vol. 36, no. 4, pp. 669-683.

31. Pascolini D., Mariotti S.P.M. Global estimates of visual impairment: 2010. Br. J. Ophthalmol., 2012, Vol. 96, no. 5, pp. 614-618.

32. Raizman M. Corticosteroid therapy of eye diseases. Arch. Ophthalmol., 1996, Vol. 114, no. 8, rr. 1000-1001.

33. Rosenberg M.E., Tervo T.M., Immonen I.J., Müller L.J., Grönhagen-Riska C., Vesaluoma M.H. Corneal structure and sensitivity in type 1 diabetes mellitus. Invest. Ophthalmol. Vis. Sc., 2000, Vol. 41, no. 2, rr. 2915-2921.

34. Sakane T., Takeno M., Suzuki N., Inaba G. Behçet’s disease. N. Engl. J. Med., 1999, Vol. 341, no. 17, pp. 1284-1291.

35. Sherman M.A., Ardashev I.V. A case of recurrent Devic’s optiomyelitis. J. Nevrol. Psychiatr. Im. S.S. Korsakova, 2015, Vol. 115, no. 2, Pt. 2, pp. 38-44.

36. Tuisku I.S., Konttinen Y.T., Konttinen L. M., Tervo T.M. Alterations in corneal sensitivity and nerve morphology in patients with primary Sjogren’s syndrome. Exp. Eye Res., 2008, Vol. 86, no. 6, rr. 879-885.

37. Tuisku I.S., Lindbohm N., Wilson S.E., Tervo T.M. Dry eye and corneal sensitivity after high myopic LASIK. J. Refract. Surg., 2007, Vol. 23, no. 4, rr. 338-342.

38. Tuominen I.S., Konttinen Y.T., Vesaluoma M.H., Moilanen J.A., Helintö M., Tervo T.M. Corneal innervation and morphology in primary Sjögren’s syndrome. Invest. Ophthalmol. Vis. Sc., 2003, Vol. 44, no. 6, rr. 2545-2549.

39. Villani E., Baudouin C., Efron N., Hamrah P., Kojima T., Patel S.V., Pflugfelder S.C., Zhivov A., Dogru M. In vivo confocal microscopy of the ocular surface: from bench to bedside . Curr. Eye, 2014, Vol. 39, no. 3, pp. 213-231.

40. Yazici H. The place of Behçet’s syndrome among the autoimmune diseases. Int. Rev. Immunol., 1997, Vol. 14, no. 1, rr. 1-10.

41. Zierhut M., Schlote T., Tomida J., Stiemer R. Immunology of uveitis and ocular allergy. Acta Ophthalmol., 2000, Vol. 78, pp. 22-25.

The intestinal microflora is involved in the development of severe autoimmune eye diseases

20 April 2015 about 14

Borovik S.P.

Keywords:

autoimmune diseases,

autoimmune uveitis,

intestinal microflora,

microbiota,

T-cells

Specialties:

Kar diology, rheumatology

Ophthalmology

Summary

Its participation in other autoimmune processes is not excluded

Gut microbiota is a trigger for severe inflammatory diseases of the eye, in particular autoimmune uveitis, scientists from the National Institutes of Health, USA, came to this conclusion, publishing the results of their study in the journal Immunity. As it turned out, some representatives of the intestinal microflora are able to produce autoantigens identical to proteins contained in the choroid of the eye (uvearetinal antigens), with subsequent activation of autoreactive T cells that attack the tissue of the retina and uvea, which determines the formation of the clinical and immunological picture of the disease.

Autoimmune uveitis is a severe inflammatory disease of the choroid of an autoimmune nature, often of a chronic relapsing nature, which can lead to significant visual impairment and blindness. According to statistics, this disease accounts for ≈15% of cases of blindness and disability due to the pathology of the organ of vision, mainly among the working-age population. The paradox of this disease lies in the fact that the eye, being a barrier organ, is isolated from the body’s immune system by the hemato-ophthalmic barrier, as a result of which it does not have immunogenic potential. Therefore, it remains a mystery: how and where does the activation of T-lymphocytes responsible for the autoimmune inflammatory process in the choroid take place?

To answer this question, scientists conducted a series of studies on animal models of spontaneous autoimmune uveitis, as a result of which the following conclusions were made: ;

extracted intestinal content activates retinospecific T-cell receptors with subsequent development of autoimmune uveitis.