Lupus is a chronic autoimmune disease where the body’s immune system mistakenly attacks its own healthy tissues and organs. This can lead to widespread inflammation and damage throughout the body, affecting areas such as the skin, joints, kidneys, and heart. Lupus can also impact various parts of the eye, leading to a range of ocular manifestations.
The Connection Between Lupus and Dry Eyes
Yes, lupus can indeed cause dry eyes. As an autoimmune condition, lupus prompts the immune system to attack healthy cells and tissues, including moisture-producing glands. This inflammation directly affects the lacrimal glands, which produce tears, leading to reduced tear production.
Additionally, inflammation can impact the meibomian glands in the eyelids, which produce oils that prevent tears from evaporating too quickly. When these glands are affected, the tear film becomes unstable, resulting in symptoms like stinging, burning, or a gritty sensation.
Sjögren’s Syndrome and Dry Eyes in Lupus
A common way lupus leads to dry eyes is through its association with Sjögren’s syndrome. Sjögren’s syndrome is another autoimmune condition where the immune system specifically targets moisture-producing glands, including the tear (lacrimal) and salivary glands. This reduces the quantity and quality of tears produced, causing significant dry eyes.
Approximately 14% to 18% of individuals with lupus also develop secondary Sjögren’s syndrome. This overlap means the immune system’s activity in lupus can extend to these moisture glands, exacerbating dryness. Even without meeting the full criteria for Sjögren’s syndrome, lupus itself can cause inflammation affecting tear production, leading to dry eye symptoms.
Addressing Dry Eye Symptoms
Managing dry eye symptoms in individuals with lupus often involves a multi-faceted approach. Over-the-counter artificial tears are frequently recommended to lubricate the eyes and alleviate discomfort. These drops can be used regularly to maintain lubrication and prevent further irritation.
For more persistent or severe dryness, prescription eye drops like cyclosporine (e.g., Restasis, Cequa) or lifitegrast (e.g., Xiidra) may be prescribed. These medications reduce inflammation in the tear glands and can help improve natural tear production over time, though full benefits may take several weeks or months.
Lifestyle adjustments can also significantly help:
Using a humidifier.
Avoiding direct air currents from fans or air conditioners.
Wearing wraparound sunglasses outdoors.
Taking regular breaks from screen time.
Applying warm compresses to the eyelids and performing blinking exercises.
Considering temporary punctal plugs to slow tear drainage.
Broader Eye Health Considerations with Lupus
While dry eyes are a common ocular manifestation, lupus can affect other parts of the eye, sometimes with more serious implications. Lupus retinopathy involves damage to the retina, the light-sensing tissue at the back of the eye, often due to inflammation of blood vessels (vasculitis) or blockages. Symptoms can include blurred vision, floaters, or changes in color vision; severe cases can affect eyesight.
Other potential eye issues include episcleritis and scleritis, inflammations of the white outer layer of the eye. Episcleritis typically causes redness and mild discomfort, while scleritis is more painful and can indicate active systemic disease, potentially leading to vision loss if untreated. Optic neuropathy, inflammation or damage to the optic nerve, is a less common but serious manifestation that can lead to sudden vision changes or loss.
Seeking Professional Care for Eye Issues in Lupus
Regular eye examinations are important for individuals with lupus to monitor for potential eye complications. Early detection and management of any ocular issues can help prevent more serious problems and preserve vision. It is particularly important to undergo routine eye screenings if taking certain lupus medications, such as hydroxychloroquine or corticosteroids, as these can have ocular side effects.
Individuals with lupus should promptly report any new or worsening eye symptoms, such as persistent dryness, redness, pain, blurred vision, or sensitivity to light, to their rheumatologist or an ophthalmologist. A collaborative approach between these specialists helps ensure comprehensive care and timely intervention for any lupus-related eye concerns.