While most people think of arthritis as inflammation of the joints, increasingly, research is showing that inflammation can cause damage in unexpected ways and in unexpected places. Unfortunately, the eyes are not immune.

Here are five eye conditions with connections to different forms of arthritis, and what you can do to protect your vision.

Keratitis sicca

What it is: Inflammation of the conjunctiva and the cornea along with decreased tear production

What you may notice: Dryness and perhaps the feeling of having something in your eye; vision may also be blurred

Seen with: Sjögren’s syndrome, adult rheumatoid arthritis (RA), scleroderma

What you can do: For eyes made dry by Sjögren’s syndrome, controlling the underlying inflammation with the medications you take for your arthritis could provide some relief, but you’ll probably also need a topical salve or artificial tears to keep your eyes moist. 

Dryness caused by medications may be relieved by switching the medication or lowering the dose. (But never make any medication changes without consulting your doctor.) Artificial tears can also offset dryness caused by medications.

Scleritis

What it is: Inflammation of the sclera, or white part of the eye

What you may notice: Redness that doesn’t go away with the use of eye drops like Visine, severe pain, sensitivity to light and perhaps reduced vision

Seen with: Adult RA, relapsing polychondritis and Wegener’s granulomatosis

What you can do: In some cases, corticosteroid drops can control inflammation, but often the problem is too deep within the eye to be controlled locally. Scleritis is usually an indication that inflammation is out of control, not only in the eye but elsewhere in the body, so keeping your arthritis under control is critical.

Uveitis

What it is: Inflammation of the uvea, the vascular layer of the eye between the retina and the sclera, or white of the eye.

What you may notice: Pain, redness, blurred vision and sensitivity to light. If not controlled, uveitis can lead to vision loss.

Seen with: Juvenile arthritis, ankylosing spondylitis, reactive arthritis, Behçet’s disease and psoriatic arthritis.

What you can do: Keeping your disease under control can help to minimize your risk, but if you notice symptoms of uveitis, contact your doctor right away. He may inject the eye with corticosteroids or prescribe corticosteroid eye drops. If local treatment isn’t sufficient to treat the inflammation you doctor may begin or increase the dose of oral drugs to suppress the immune system. If an infection is the cause, antibiotics may be needed. 

Retinal Vascular Occlusion

What it is: Small blood vessels that feed the retina, or light sensing layer of the eye, become blocked or backed up, akin to what happens during a heart attack or stroke.

What you may notice: Vision loss, like a curtain coming over the eye. If an artery is blocked, loss of vision may happen suddenly and come and go. If a vein is backed up, vision loss may be more gradual.

Seen with: Lupus, scleroderma, Behçet’s disease, sarcoidosis, polyarteritis nodosa and primary CNS angiitis

What you can do: If an artery has been blocked, damage may be permanent and there is currently no known treatment to restore vision. If a vein is backed up, laser surgery may help reduce swelling and restore vision.

Glaucoma

What it is: A condition in which fluid pressure in the eye rises slowly, causing damage to the optic nerve

What you may notice: Eye pain, vision that’s blurry or has blank spots, rainbow-colored halos around lights. In its early stages, glaucoma has no symptoms.

Seen with: Glaucoma can be a side effect of corticosteroid therapy for arthritis.

What you can do: The best way to prevent glaucoma related to corticosteroid therapy is to work with your doctors to minimize corticosteroid use, taking the lowest doses for the shortest time to produce desired results.

Regular eye exams can identify the problem early and improve prognosis.

Treatment for glaucoma involves local preparations and beta-blocker eye drops to reduce pressure in eye. If those aren’t successful, surgery can be used to increase the flow of aqueus fluid from the eye and lower pressure.