Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine, leading to pain and stiffness. This condition is also associated with inflammation in other parts of the body, including the eyes. The most common eye complication linked to AS is anterior uveitis, also referred to as iritis. Awareness of eye symptoms is particularly important for individuals with AS.
Understanding Eye Inflammation
Anterior uveitis, or iritis, involves inflammation of the front part of the eye. It affects the iris, the colored part of the eye, and the ciliary body, a structure behind the iris that helps with focusing and produces fluid. This inflammation manifests as redness and swelling. The condition typically has a sudden onset and can recur in episodes.
Recognizing the Symptoms
Individuals with anterior uveitis may notice several distinct symptoms. Common signs include deep eye pain and noticeable redness, particularly around the iris. Sensitivity to light, known as photophobia, is also a frequent symptom, making bright environments uncomfortable. Blurred vision and excessive tearing are further indicators of this eye inflammation. These symptoms typically affect one eye at a time, though they can shift between eyes or reappear in the same eye during subsequent episodes.
Diagnosis and Treatment
Diagnosis of anterior uveitis is made by an ophthalmologist, an eye care specialist, through a thorough examination. This involves assessing the patient’s reported symptoms and conducting a physical examination of the eye using a specialized microscope called a slit lamp. It is important to seek immediate medical attention if any of these eye symptoms appear, as timely treatment is necessary to prevent potential complications like cataracts or glaucoma.
Primary treatment approaches typically involve corticosteroid eye drops, which work to reduce the inflammation within the eye. Additionally, dilating eye drops are often prescribed; these drops help to relieve pain and prevent complications such as synechiae, a condition where the iris adheres to the lens. In cases of severe or frequently recurring inflammation, systemic medications, including biologic drugs used to treat AS, may be considered to manage the underlying inflammatory response.
Why Eyes Are Affected
Ankylosing spondylitis is classified as an autoimmune condition, meaning the body’s immune system mistakenly attacks its own healthy tissues. In some individuals with AS, this misdirected immune response can extend to tissues within the eye, leading to eye inflammation. A genetic predisposition plays a role in this connection, particularly the presence of the HLA-B27 gene. While many people carry the HLA-B27 gene, only a subset will develop AS or associated eye inflammation, indicating that other factors also contribute to the disease’s manifestation.