Autoimmune disorders can affect every inch of your body, from your nerves and joints to your eyes.
But with more than 80 different autoimmune disorders in existence, it is difficult to catalog all the possible impacts on your vision.
You need to be informed about the risks that your specific autoimmune disorder poses to your vision and to seek assistance if you start to experience changes, such as cloudiness, blurriness, pain, dryness, or light sensitivity.
The impact of autoimmune disorders on your eyes can be lessened with appropriate medication.
“There are several areas of the eye that are involved in autoimmune disease,” says ophthalmologist Alan H. Friedman, MD, clinical professor of ophthalmology and pathology at the Mount Sinai School of Medicine in New York City. “There are probably common building blocks, like proteins and sugars, that are involved, so that when one area of your body is affected, your eye can be affected also.”
On such problem is autoimmune retinopathy, which is “usually manifested as a vascular problem,” says Dr. Friedman. This means that the immune system attacks and inflames the blood vessels in the back of the eye, on the retina, which can affect vision.
Autoimmune Disorders: See Your Eye Doctor Regularly
One of the most important things you can do to protect your eyesight is to see your ophthalmologist regularly. The American Academy of Ophthalmology, a professional organization for eye doctors, advises all adults to get an eye screening at age 40 if they have not seen an eye doctor previously. If you have an autoimmune disease:
- You should not wait until age 40 for a vision health screening. See an ophthalmologist now if you have not been to one in the past year.
- Make sure you ask your eye doctor about how often you need to be screened.
- Get screened more frequently (even as much as every six months) if you have symptoms of vision health problems.
- You should also get frequent eye exams if you are taking certain autoimmune disorder medications for treatment, such as Plaquenil (hydroxchloroquine), which is known to affect eyesight.
Autoimmune Disorders Linked to Vision Health
There are many autoimmune disorders that affect the eye, including:
- Behcet disease. This rare autoimmune disorder is a leading cause of blindness in some developing countries. Eye symptoms may be accompanied by mouth and genital sores.
- Lupus. Eye inflammation is one of the many possible effects of lupus. Symptoms include blurred vision, headaches, sore eyes, dry eyes, and sensitivity to light.
- Multiple sclerosis (MS). The connection between vision health and this autoimmune disorder is so strong that eye doctors may be the first ones to suspect an autoimmune disorder, says John Rose, MD, director of the Center for Autoimmune Disease Research at Johns Hopkins University in Baltimore. Initial symptoms of MS often include optic neuritis, which is a gradual or sudden loss of vision due to inflammation of the optic nerve – the large nerve entering the back of the eye.
- Psoriasis. Inflammation of the conjunctiva (the clear membrane covering the undersides of your lids and the whites of your eye) can cause redness and pain in your eye.
- Reiter’s syndrome. In addition to causing joint inflammation, reactive arthritis can cause inflammation of the front part of your eye.
- Rheumatoid arthritis (RA). RA can cause dryness, inflammation of the white of the eye, thinning of the cornea, and other painful ocular conditions.
- Sjogren's Syndrome. This chronic inflammatory condition can lead to dryness of the eye due to an autoimmune attack on the tear-producing glands.
- Thyroid diseases. Autoimmune disorders that result in either high or low thyroid function increase the risk of glaucoma (a condition of high pressure inside the eye). Research to understand this relationship is ongoing, but it is thought that with hyperthyroid conditions such as Graves’ disease, tissues build up around the eye and increase pressure in that way. With low-thyroid disorders, the eye may not be able to circulate its fluids effectively, causing pressure to build up from the inside.
- Type 1 diabetes. This autoimmune disorder is one of the leading causes of blindness in the United States, because chronic poor blood sugar control can cause damage to the small blood vessels in the back of the eyes.
- Ulcerative colitis and Crohn’s disease. About 5 percent of patients will have “nonspecific inflammation of the eye.”
- Uveitis. This is an autoimmune disorder that directly affects the pigmented cells of the iris in the eye, and sometimes the middle layers of the eye as well. It causes inflammation, which can lead to blurred vision, “floaters,” and redness of the eye. Uveitis can occur alone, or may be a symptom of another autoimmune disorder.
Vision Health and Autoimmune Disorder Treatments
Some medications for autoimmune disorders may have adverse effects on your vision health over the long term, including:
- Corticosteroids. Long-term use can cause cataracts and increase the risk of glaucoma.
- Antimalarials. Plaquenil can occasionally cause decreased vision.
If you have an autoimmune disease, you are probably alert to changes throughout your body — but don’t forget to take care of your eyes with regular screenings and attention to vision changes.