What Doctors Are Saying
A lot of my patients have seen great success in using a combination of scheduled in-practice treatments as well as daily, at home treatments to improve management of Dry Eye.
Dr. Jeff Goodhew
Oakville, ON
With advancing technology we now can image the damaged structures that can cause dry eye disease and recommend preventive measures to improve future eye health.
Dr. Trevor Miranda
Duncan, BC
Practicing with a focus on dry eye disease has allowed our patients to get appropriate and adequate care for a disease that has been under diagnosed for decades. Finally we have the tools and scientific support to get people the help they need to preserve their visual comfort.
Dr. Richard Maharaj
What Is Psoriatic Arthritis
Psoriatic arthritis is a chronic, inflammatory disease of the joints where tendons and ligaments connect to bone. Like psoriasis, PsA is associated with related health conditions .
It can start at any age and may affect children. The disease often appears between ages 30 and 50.
For many people, it starts about ten years after psoriasis develops. Still, some develop psoriatic arthritis first or without ever developing or noticing psoriasis.
Controlling Inflammation Helps Your Body And Your Vision
The treatment of eye inflammation always requires a comprehensive treatment plan to combat inflammation. It will make a tremendous difference if you get a treatment plan from a doctor for arthritis at early stages.
If you are suffering from an underlying problem like arthritis, you should find the correct treatment. Consult your ophthalmologist frequently for professional medical advice.
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How Can Eye Problems Be Managed And Treated
Managing and treating eye conditions goes hand in hand with keeping a persons RA symptoms under control. For dry eyes, Dr. Sparks suggests using local lubricating agents, such as eyedrops for short-term relief.
One myRAteam member shared their positive experience with eyedrops. I am now doing eyedrops multiple times a day and using an eye gel at night. My eyes are starting to feel a little better. Before, I would blink and it felt like sandpaper rubbing over my eyeballs.
For inflammatory eye conditions such as PUK, scleritis, and uveitis, immune system-reducing drugs , and topical or oral steroids are initially used to reduce the bodys inflammatory response to the eyes. However, long-term steroid use can negatively affect a persons vision and may lead to the development of other eye diseases, such as cataracts or glaucoma.
Nonsteroidal anti-inflammatory drugs like ibuprofen, eyedrops, or injections might be used as an alternative treatment. It is important to discuss treatment plans with your rheumatologist and/or ophthalmologist to help preserve your overall vision.
Treatment For Psoriatic Arthritis
Though there is no cure, a growing range of treatments is available to help stop the disease progression, lessen pain, protect joints, and preserve a range of motion.
Suppose you suspect you may have psoriatic arthritis. In that case, it is essential to work with a rheumatologist to find the right treatment plan.
Early recognition, diagnosis, and treatment of Psoriatic arthritis can prevent or limit the extensive joint damage in later stages of the disease.
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Which Eye Conditions Are Caused By Rheumatoid Arthritis
Dry eyes
Dry eyes are one of the most common problems caused by RA. This is because RA causes inflammation in your eyes tear glands, reducing fluid output in the eyes. This in turn leads to an itchy, grit-like sensation in your eyes, resulting in a red appearance and occasionally blurred vision. Dry eyes usually can be treated with over the counter eye drops, or punctal plugs and thermoflow treatment in more severe cases. It is important to treat dry eyes as, if ignored, the condition can cause corneal damage.
Scleritis
Scleritis is a condition whereby the whites of your eyes the sclera become red and inflamed. You might also experience light sensitivity, blurred vision or eye pain alongside this. Normal hydrating eye drops wont help this inflammation, so your doctor may prescribe steroid eye drops or immunomodulator medications. If you notice any of the symptoms of scleritis, its crucial that you seek medical help as quickly as possible. If left untreated, your vision can worsen beyond repair.
Iritis and uveitis
Floaters
Cataracts
Glaucoma
Corneal damage
Retinal vascular occlusion
The Structure Of The Eye And Where Arthritis Strikes
The eye is a complicated structure. Different types of arthritis can cause different types of eye problems. Its important to understand some general eye anatomy:
The entire eye is covered by a white outer coat called the sclera. The sclera is covered by a thin semi-transparent mucous membrane that has blood vessels, which is called conjunctiva.
At the very front of the eye is the cornea, which is the transparent layer that transmits and focuses light.
Behind the cornea is the iris, which is the colored part of the eye that helps regulate the amount of light that enters the eye like the diaphragm of a camera. The pupil is the dark hole in the middle of the iris, which adjusts in size to let in more or less light.
Just behind iris and pupil is the lens, which is like the lens of the camera. The lens is suspended in the eye cavity through some fine fibrils that attach to the ciliary body.
The back of the eye contains these important structures:
- Choroid: A layer that contains blood vessels, located between the sclera and retina
- Retina: A nerve layer that lines the back of the eye it creates electrical impulses from light that are sent to the brain via the optic nerve
- Macula: An area in the retina with special light-sensitive cells
- Optic nerve: A bundle of nerves that transmits visual messages from the eye to the brain
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Inflammation And Irritation Of The Eyes Due To Rheumatoid Arthritis
Inflammation, redness, and irritation of the eyes may occur in people who have rheumatoid arthritis. Certain types of eye inflammationare associated with rheumatoid arthritis.
- Iritis is the inflammation of the iris, or colored part of your eye. Irritation can produce blurred vision, floaters in your sight, or other visual problems.
- Scleritis is inflammation of the sclera, the white outer layer of the eye. You will most likely experience irritation, pain, sensitivity to light, and even visual problems if you develop this.
- Uveitis occurs at the very center of the eye, or the uvea. The symptoms are very similar to the symptoms associated with iritis.
How Psoriatic Arthritis Affects Your Eyes
Both psoriasis and psoriatic arthritis are autoimmune diseases. That means they cause your body to attack itself by mistake. This can trigger inflammation in certain parts of the body, including your eyes.
If your eyes are irritated and you have psoriasis, you may have uveitis. Thatâs a term for any inflammation inside your eye. It can lead to swelling and damaged eye tissue. Uveitis may affect one or both eyes. Symptoms include:
Your eye doctor can treat pinkeye.
Glaucoma. This is a group of conditions that damage your optic nerve. It often starts with inflammation that causes a buildup of pressure in your eye. Symptoms include:
You may not have any of these if the disease is in its early stages. Thatâs why regular eye exams are important. Your eye doctor can catch it even if yoâre not showing symptoms. Glaucoma can also be a side effect of taking corticosteroids for psoriatic arthritis. Talk to you doctor about how to lower this risk.
Cataracts. That âs when inflammation turns the clear lens of your eye cloudy. Symptoms can include:
- Trouble seeing at night
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Procedures To Address Dry Eyes
There are some medical procedures that might be considered for dry eyes, including:
- The use of special contacts designed to protect the surface of your eye and prevent moisture from escaping.
- A procedure known as the LipiFlow Thermal Pulsation to clear blocked oil glands in the eye.
- A procedure using punctal plugs made of silicone to block your tear ducts. This can help to retain moisture in the eyes.
Treatment Of Eye Problems Related To Rheumatoid Arthritis:
Early eye detection is important for your treatment of Rheumatoid arthritis. When the condition of RA is detected and treated early and the inflammation is reduced, you will be less likely to develop eye disorders caused by Rheumatoid arthritis.
Using eye drops, warm compresses, and topical lubricants, you can treat your eye complications. These treatments can help in relieving redness, dryness, and itching. The best eye drops are those drops without preservatives.
For severe cases of inflammations that do not respond to eye drops, you should consult with your doctor. They would recommend you a topical steroid or immunosuppressive medications. They are basically applied twice a day for treating the underlying inflammation.
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How Often Should My Child With Jia Have Eye Examinations
The frequency of your child’s eye exams will depend on the type of JIA he or she has, how long your child has had arthritis and what medicines have been prescribed to treat it.
Because uveitis is more common in children with certain types of JIA, such as oligoarthritis, or in polyarthritis with a positive ANA, more frequent eye examinations might be recommended. Children with polyarthritis require an examination every six months and patients with systemic JIA usually need an ophthalmologist examination every 12 months. Eye exams should continue after your child’s arthritis goes into remission because eye inflammation can occur even when JIA is not active.
Ask your rheumatologist and ophthalmologist how often your child’s eye exams should be scheduled and follow their recommendations. If eye problems are detected, more frequent examinations will be necessary.
What Happens During An Ophthalmologist Appointment
The eye exam performed by the ophthalmologist is painless and lasts several minutes. Be sure to tell the ophthalmologist about the medicines your child is taking.
Prior to the eye exam, the ophthalmologist will put drops in your child’s eyes to make the pupils bigger . Dilating your child’s eyes helps the doctor clearly view the inside of the eyes.
To detect eye inflammation, the ophthalmologist uses a special microscope called a slit lamp. The machine shines a thin beam of light into one eye at a time so the doctor can view the inside of the eyes.
A visual field exam might also be performed to detect vision changes.
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Eye Concern #: Blurred Vision From Peripheral Ulcerative Keratitis
PUK is, fortunately, rarebut its a serious condition involving inflammation in the blood vessels of the eye or an ulceration in the cornea, the clear layer over the front of the eye. Symptoms of PUK are similar to those of uveitis and scleritis , including redness, pain, sensitivity to light but PUK can also lead to blurred vision. Sometimes patients with PUK complain that things look fuzzy because swelling can distort the lens of the eye, says Dr. Feinberg.
How Does Rheumatoid Arthritis Affect The Eyes
The main ways in which RA can affect your eyes are:
- Keratoconjunctivitis Sicca : The inflammation that RA causes can negatively affect tear glands, reducing fluid secretion resulting in dryness. The symptoms include a feeling of dirt or debris in the eyes, redness ad blurred vision.
- Scleritis: In this condition, RA causes inflammation on the sclera , which becomes thinner with the swelling and can easily split with a minor injury. It is more likely to happen among people between 40 to 70 years old. Symptoms of scleritis include reddening that does not fade, itchiness, sporadic vision problems, pain and swelling.
- Uveitis: In Uveitis, RA causes inflammation in the uvea. Uvea is the vascular section of the eye found between the retina and the sclera. Symptoms of the condition include pain, redness, light sensitivity, and blurred vision.
The different eye conditions that RA causes call for immediate doctor’s attention and treatment. Left unchecked, they could easily cause scratching, scarring, and even ulceration of the cornea. These or other negative effects of the conditions can lead to loss of vision.
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How Can Arthritis Affect The Eyes
A person with arthritis has complete knowledge of what this inflammatory disorder can do. Arthritis causes pain and swelling in the joints to an extent that even doing daily activities becomes a challenge. Generally, arthritis affects the joints of the hands and feet. However, there are times when the eyes can also get affected with arthritis. It has been estimated that approximately 1 in every 5 people above the age of 18 have some form of arthritis or the other. Arthritis has no racial or gender bias and can affect anyone at any age and interfere with their quality of life significantly.
One form of arthritis called rheumatoid arthritis is known to affect the eyes but it is generally overlooked and underdiagnosed due to other manifestations that are seen with this condition. Ocular manifestations are seen mostly in people who have longstanding rheumatoid arthritis. It usually affects the anterior chambers of the eyes causing medical conditions like keratoconjunctivitis sicca, scleritis, anterior uveitis, and ulcerative keratitis.
Rheumatoid arthritis damages the collagen which is the primary component of the cornea and sclera. Generally, both the eyes get affected by rheumatoid arthritis. The ocular manifestations of arthritis are mostly seen in females and tend to get worse with the progression of the disease. The article below highlights how arthritis affects the eyes and what the conditions that are caused by it.
Eye Concern #: Retinal Toxicity
Cruel irony: Some of the medications that we use to treat rheumatoid arthritis can potentially cause eye problems, says Dr. Feinberg. One top culprit? Quinolines , which are classified as anti-malaria drugs but are commonly used for RA because they treat inflammation. They can build up in the eye and affect vision or even damage the back of the eye and cause loss of vision, Dr. Feinberg explains, a condition called retinal toxicity.
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Making The Most Of Your Eyesight
Date: 11/07/2020
Did you know that from the age of 40 our eyes change rapidly? And by the age of 65, we will need three times more light to see than we did at 20?
As we grow older, our eyes take longer to adjust to sudden changes in light and dark. They are more sensitive to glare and are less able to judge distance and depth. This, in turn, can affect your ability to see the edges of steps, stairs, footpaths and kerbs.
Your eyes not only allow you to see obstacles and judge steps, they also play an important role in helping you to keep your balance. Gradual changes in eyesight, which we may not actually notice, can increase a persons risk of having a fall.
Bifocal, trifocal or multifocal glasses can also increase a persons chance of falling, as the changes in the lens can make it more difficult to judge distances and see objects on the ground. Other eye conditions, such as macular degenerationor glaucoma, can also impair a persons vision.
So, what can you do to maximise your eyesight and reduce the risk of fall?
Have your eyesight and glasses checked by an optometrist at least once every two years and yearly by a doctor.
If you notice changes in your eyesight, make an appointment with your doctor or optometrist. Early detection of eye problems can stop them from becoming worse.
Keep your glasses clean and always wear the correct glasses reading glasses for reading and distance glasses for driving or walking around.
Reference:
The Importance Of Regular Eye Care
The most effective way to diagnose and control inflammation of the eye is to consult your rheumatologist a day before any surgery for any eye condition. If there is an apparent eye-related symptom, you can call the eye doctor for medically reviewed opinion and advise.
A yearly dilated ear examination is essential to see early underlying conditions and damage. The most common eye disorders are not very painful or can have very poor vision.
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Eye Concern #: Glaucoma
Caused by increased pressure inside the eye that can damage the optic nerve, glaucoma tends to be a genetic condition that strikes later in lifebut it also can be a side effect of eye inflammation from RA, says Dr. Bhatt. Often, glaucoma patients dont have symptoms until the late stages, when they start having tunnel vision and seeing halos.
Prescription Medications For Dry Eyes
You might get a prescription medication from your doctor to address dry eyes. Most of these focus on reducing inflammation, or they may be antibiotics. Restasis can be used to treat inflammation.
If regular OTC medications are not working, your physician might consider using eye inserts to address the situation.
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How Rheumatoid Arthritis Affects Your Eyes
At least 18% of people with rheumatoid arthritis develop eye disease. And when you consider the most common problem, dry eyes, the number may be as high as 44% of all rheumatoid arthritis patients.
Dry eyes and other eye diseases that commonly develop as a result of rheumatoid arthritis can cause serious complications, potentially leading to vision loss. Stephen Wolchok, MD, at Wolchok Eye Associates in Jacksonville, Florida, protects your eyes with individualized treatments that ease your symptoms and help prevent serious eye problems.
Heres what you need to know about how rheumatoid arthritis affects your eyes and the types of eye problems you may develop.