uveitis and rheumatoid arthritis


I went to the ophthalmologist for another check yesterday.  It’s a very inconvenient appointment because I need someone to drive me.  The exam involves numbing drops that dilate your pupils, which means you can’t focus and the world is a blur for a few hours.  You clearly can’t drive.

I won’t waste too many words on how great it feels to be 41 years old and have to ask your mummy to drop you off at the ophthalmologist.   And then to ask your husband, whom you have been separated from for a year now, to pick you up.  I think you can imagine…

Anyway, my eyes are fine.  The black floaters are not dangerous.  There is no damage to my vision; I just need to keep using lubricating drops daily.  Probably forever.  Just another bit of maintenance.

But it got me thinking again about all the complications and comorbidities of Rheumatoid Arthritis.  Like iritis.

What is iritis?

Iritis is inflammation of the iris (the colored part of the eye).  It is a form of uveitis, and is more correctly termed anterior uveitis.  It is a common comorbid condition in Rheumatoid Arthritis and Ankylosing Spondylitis and other forms of inflammatory arthritis.

Symptoms of iritis

Iritis usually presents as a red, painful eye.  Sometimes patients experience blurred vision, and sensitivity to light.    The pupil may be constricted.  This all sounds pretty minor, but iritis is serious and can be very painful.

How is iritis diagnosed?

You need to see an ophthalmologist who will examine your eye with a slit lamp.  They will be able to see white blood cells and protein particles in the fluid inside the eye.

Treatment of iritis

Steroid eye drops are often prescribed to reduce inflammation in the eye.  Drops to dilate the pupil are also used to stop the iris muscles spasming and allow the iris to rest and heal.

Beyond this, at home treatment may involve staying in a darkened room, as patients can become very light sensitive, which causes eye pain and headache.  A good quality pair of sunglasses is essential, to protect the eyes.

I wear my sunglasses inside sometimes on bad days.  Even the light from the laptop screen is too bright some days, and hurts my eyes.  It’s very frustrating, and prevents me from achieving much!

A bout of iritis usually lasts a few days.  But it is recurrent, and you never know when you are going to wake up with blurred vision and eye pain.  It will usually be when you have that interview for that great part time, work at home job.  Or the lunch date with all your best girlfriends.

Complications of iritis

Iritis can cause blindness, but this is very rare.  Vision damage can occur, as can glaucoma.  It’s essential to keep having regular checks with an ophthalmologist if you have chronic or recurrent iritis.  Each recurrence increases the changes of scarring, cataracts or glaucoma.

There’s not much you can do to prevent an attack.  If it recurs often, it’s wise to have steroid drops on hand, to treat the problem quickly.



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