An inflamed eye with a health "+" sign in the pupil and droplets of relief in the background.

Sudden Eye Issues

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After my diagnosis with juvenile rheumatoid arthritis (now juvenile idiopathic arthritis) as a child, I have made regular visits to the ophthalmologist to get my eyes checked.

At the time, I didn’t understand why but later learned that the disease posed a risk to my eyes and that the medication I was taking (Plaquenil) could also injure my eyes.

Lucking out as a child

Thankfully as I grew up, I never had any additional eye problems, other than the genetic family propensity towards near-sightedness. Also, medication changes over the years meant I hadn’t taken Plaquenil for a long time and had lucked out with no eye damage.

Still, I kept up with annual visits to an ophthalmologist in order to make sure my eyes were doing okay with the long-term effects of RA. This became even more important a few years ago when I tried Plaquenil again for a short period of time.

However, it wasn’t long before my liver levels were up and my doctor decided the medication wasn’t working for me. Thankfully, I lucked out again, as my eyes remained undamaged and my liver test results returned back to normal.

An episode of eye irritation

I feel fortunate to have gotten this far through my life with RA and not had to deal with eye issues, until recently.

Was this a case of episcleritis?

One morning I woke up with a burst blood vessel and a bump on the white of my left eye. Since I already had an appointment with my rheumatologist, I went to see him and he advised that I visit my ophthalmologist to get it checked out for the possibility of episcleritis or inflammation of the white part of the eye.

The next day I visited my ophthalmologist and just about immediately he said: "This is no problem; this is normal irritation and should go away in a few weeks." Phew, I was so relieved. Not only did the ophthalmologist not see a significant problem with my eye, but he affirmed that my vision was still normal.

Eye complications can happen suddenly

I admit that I was very anxious about my eye because the change had come on very suddenly and a friend with RA had just told me that they were diagnosed with episcleritis and that it was uncomfortable. (My friend actually sees the same ophthalmologist for their RA eye maintenance, so I feel confident in the doctor’s expertise and diagnoses.)

The ophthalmologist recommended using some “natural tear” drops to help lubricate and soothe my eye. This has not been easy for me as I am a blinker and balker when it comes to my eyes. However, when a drop makes it, it does relieve the dry scratching I have been feeling.

Monitoring our eyes is important

Unfortunately, eye issues in RA patients are not uncommon. The disease causes inflammation in all sorts of places in the body, not just the joints.

I have long been aware (since my teenage years) that I have dry eye, and sometimes dry mouth, and trouble swallowing which can be Sjogren’s symptoms as well.

My guess is that my chronic dry eye leaves me susceptible to eye irritants because I cannot produce tears to flush then as well or as quickly. Thus, a bothered eye that bursts a blood vessel and experiences tiny irritating cysts on the eye until it has the time to heal and be lubricated by tears.

Stay vigilant and seek medical care quickly

While I don’t blame my RA for this specific problem, it does feel to me as if it is "RA adjacent." By that, I mean that my condition fosters my dry eyes, which leaves them susceptible to irritation and injury.

I feel lucky to not have something more serious that damaged my eyes, but I’m also glad that I was vigilant and went to seek medical help quickly.

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