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Ocular manifestations of rheumatoid arthritis

Author
Reza Dana, MD, MPH, MSc
Section Editors
Ravinder N Maini, BA, MB BChir, FRCP, FMedSci, FRS
Jonathan Trobe, MD
Deputy Editor
Paul L Romain, MD

INTRODUCTION

Rheumatoid arthritis (RA) is a common and chronic systemic inflammatory disease of unknown etiology that primarily involves joints. Extraarticular manifestations are also observed, including ophthalmic involvement. The clinical course of the ocular disease may be quite variable.

The importance of the early diagnosis of ophthalmic disease in the patient with RA cannot be overemphasized, since it permits the timely management of potentially serious sight-threatening complications. The presence of ocular disease may also be an indication of ongoing systemic disease activity [1,2]. However, ocular involvement, in particular severe dry eye, may exist independently from severe articular disease and should be evaluated in all patients with RA regardless of extra-ophthalmic manifestations [3].

Issues relating to the ocular manifestations of RA are discussed in this review. The anatomy of the relevant structures is depicted in the figure (figure 1). The articular and other nonarticular clinical manifestations of this disorder are discussed separately. (See "Clinical manifestations of rheumatoid arthritis" and "Overview of the systemic and nonarticular manifestations of rheumatoid arthritis".)

INDICATIONS FOR URGENT REFERRAL TO AN OPHTHALMOLOGIST

Urgent referral to on ophthalmologist with expertise in the management of ocular inflammation or corneal-external diseases of the eye should be carried out in patients with rheumatoid arthritis (RA) who present with any of the following:

Significant change in visual acuity over a period of several days or weeks

             

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Literature review current through: Nov 2016. | This topic last updated: Mon Jul 06 00:00:00 GMT 2015.
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