Ophthalmological symptoms of rheumatic diseases

Relevance Eye involvement in rheumatic diseases is associated with common immune mechanisms that cause inflammation not only in the joints but also in the eye structures [1]. Unique eye symptoms are often the first manifestations of diseases, which emphasizes the importance of physician awareness [2]. Rheumatoid arthritis is a chronic disease that manifests itself as erosive arthritis and systemic organ damage, which shortens life expectancy [3]. Treatment of ulcerative keratitis and necrotizing scleritis includes glucocorticoids, immunosuppressants, and genetically engineered biologics [4]. Systemic vasculitides can affect the eyes, manifesting as uveitis or scleritis. Ankylosing spondylitis affects the axial skeleton. In reactive arthritis, uveitis occurs together with conjunctivitis caused by infections. SCC is the main symptom of RA with severe consequences for the lacrimal glands. In GPA, bilateral necrotizing lesions and nodules are observed. Examination may reveal avascular areas, scleral thinning, and small corneal infiltrates [5]. Between 20% and 40% of patients with ankylosing spondylitis have episodes of uveitis. In systemic lupus erythematosus, symptoms are observed in 50% of patients. Episcleritis is recorded in 1% to 5% of patients with RA. Eye inflammation may be the first sign of GPA in 10% to 30% of patients. Diagnosis includes a thorough anamnesis, blood tests for the presence of the HLA-B27 antigen, and pelvic radiography/MRI of the sacroiliac joints to detect sacroiliitis, a key feature of SpA. Conclusion Knowledge of the ocular pathology and assessment of symptoms is critical for diagnosis and therapy. Treatment requires collaboration between an ophthalmologist and a rheumatologist. Key words: rheumatic diseases; inflammatory eye diseases