Ocular manifestations in rheumatoid arthritis

Background: Rheumatoid Arthritis (RA) is a chronic systemic autoimmune disease that often presents with extra-articular manifestations, including ocular involvement. Early identification and management of ophthalmic manifestations are critical to prevent vision-threatening complications. Objective: To study the different ophthalmic manifestations in patients diagnosed with Rheumatoid Arthritis. Methods: This prospective observational study was conducted at BGS Global Institute of Medical Sciences between July 2024 and January 2025. A total of 26 RA patients referred from the Orthopaedics Department were included based on specific inclusion and exclusion criteria. All participants underwent a comprehensive ophthalmic evaluation including visual acuity, slit-lamp examination, Schirmer’s test, Tear Film Break-Up Time (TBUT) and fluorescein staining. Dry eye disease (DED) grading was done according to the DEWS II classification. Results: Among the 26 patients, 73% were female and 27% were male, with a mean age of 44.69 ±7.31 years. The most common ophthalmic manifestation was Keratoconjunctivitis sicca (34.6%), followed by anterior uveitis (11.5%), episcleritis (7.7%), scleritis (3.8%), and peripheral ulcerative keratitis (3.8%). Of the patients with DED, 66.7% had mild, 22.2% had moderate, and 11.1% had severe disease.