Sjogren’s Syndrome and Rheumatoid Arthritis

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For the last few months my eyes have been feeling gritty and dry from time to time.  Every few weeks I wake up with puffy eyes, the whites all bloodshot and an inflamed.  They hurt, especially in bright light.  It looks like a bad allergic reaction.  Or maybe I’ve been sobbing uncontrollably for the last month or so.  But it’s not that.  It’s rheumatoid arthritis attacking my eyes.   For the last few weeks it has been happening more often.  The last week it has been constant.  Last Thursday was so bad I went to my GP.  She suspected Sjogren’s Syndrome, and sent me off to see my ophthalmologist.

I was very lucky to be given an ‘emergency’ appointment the next day.  I’ve been feeling increased pressure in my eyes, but put that down to the truckload of prednisone I’ve been taking lately.  I’ve also got a lot of black floaters and blurred vision. The blurring is mostly around the edges, and some days I have ‘tunnel vision’.   Still fine in the centre of my field of vision though.

These changes are a bit of a concern, so getting it checked out quickly is essential.  Luckily there is no damage to my eyes as yet.  My ophthalmologist gave me some over the counter eye drops and gel (Refresh eye lubricant) and told me to come back in three months for another check.

The eye exam is thorough.  They use drops to numb your eyes and dilate your pupils so you can’t see properly for several hours afterwards.  You need someone to drive you and pick you up.  It pretty much takes out the whole day.  It is, in short, a pain in the butt.

But losing even some of your vision is a very scary prospect, so I will dutifully return in three months for another check.  I’m also on plaquenil, so I have been having these checks every two years, anyway.  Now I guess I just have to go a bit more often.  Another regular specialist appointment to add to my schedule.  No wonder I can’t hold down a *real* job – I don’t have time!

My ophthalmologist was lovely.  Considering my rheumatoid arthritis diagnosis, she suspected Sjogren’s syndrome right away.  She could do further testing, but the eye exam is enough.   Another diagnosis to add to my list.  We autoimmune types tend to collect them as we go.

She was sympathetic about the pain that dry eyes can cause.  She was honest about the fact that there may be days when I just have to sit at home in the dark because I am so photosensitive.  She realised it was just ‘one more thing’ to deal with.  She advised me to think about caring for my eyes, in the same way I care for my teeth.  She suggested I keep my eye drops with my tooth brush, and when I brush morning at night, I also put my drops in.  Very simple.  Good advice.  Delivered with kindness.

And she hoped that it would resolve, and maybe even go into remission.  I am already taking prednisone and plaquenil – drugs often used to treat Sjogren’s syndrome.  If there is no improvement in three months, she will prescribe Restasis – cyclosporine eye drops.  So there are still options.

I’ve been using the eye drops and gel for a few days now.  I can’t say they help much.  I keep the house darkened, because the light hurts my eyes still.  My house is kinda dingy and depressing.  I wear sunglasses religiously – even indoors.  I looked like a total dork at the shops because I wore my sunglasses at the grocery store.   I know people were laughing at me.  But at least I gave someone a reason to smile today.

3 COMMENTS

  1. I have dry eyes too, but what bothers me most is that I have a hard time seeing stuff straight on…didn’t know if it’s RA related of Old age related…if I tilt back I can see clearer. Worries me because several in our family have macular degeneration…. =*(

    • Hi Claudia, it sounds like you should take a trip to your eye specialist as well. You eye sight is too important to risk…its worth checking it out. Good luck, let us know how you go.

      Arthritic chick signature

  2. I found a wonderful doctor at the University of Pennsylvania hospital that specializes in Dry Eyes. She explained that dry eyes are a result of not just lack of tears, but also oil glands in your eyelids that are clogged usually due to inflammation. She does IPL (Intensive Light Therapy) therapy on my eyes 2-4 times a year. It enables her to get the oil flowing which lubricates your eyes and keeps your tears from evaporating. It is not covered by insurance, but it is worth it. Some local ophthalmologists are starting to do this treatment as well. Before this I tried every drop on the market and wanted to rip my eyes out. Good luck.

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