Rheumatoid arthritis (RA) is a highly inflammatory disease that can lead to joint destruction, deformity and loss of function. RA can cause irreversible joint damage and significant disability. It has a prevalence of 1% and occurs in twice as many women as men.
What Causes Rheumatoid Arthritis
The etiology of RA remains unknown, but it appears to involve the combination of repeated exposure to environmental agents and genetic predisposition to autoimmune responses.
Dryness (Sicca) in Rheumatoid Arthritis
Dryness symptoms are increased in patients with RA.
- Increase with age,
- Severity of the disease.
Rheumatoid Arthritis directly contributes to sicca, as evidenced by the increase in the risk of persistent oral and ocular dryness in RA compared to normal subjects.
Secondary Sjogren’s Syndrome
When severe oral and ocular symptoms are combined with salivary gland involvement, Sjogren’s syndrome may be diagnosed in conjunction with the RA. This is known as secondary Sjogren’s.
Dry Eye Symptoms of Rheumatoid Arthritis – Keratoconjunctivitis Sicca
Chronic dry eyes, Keratoconjunctivitis sicca is the most common ocular manifestation of RA and has a reported prevalence of 15% to 25%. Symptoms are usually prominent during the latter part of the day due to evaporation of the tear film. The lacrimal glands can be assessed with Schirmer testing or with the less invasive phenol red thread testing (Zone-Quick). Phenol testing takes less time and will adequately assess tear production.
Complications of Dry Eyes in Rheumatoid Arthritis – Cornea Abrasion
Evidence suggests that the dry eye precipitated by RA is associated with ocular surface inflammation that may further compromise tear secretion and cause ocular surface disease and irritation symptoms. Using steroids along with conventional dry eye therapy is often used.
Conventional Treatments for Dry Eyes in Rheumatoid Arthritis
Dry eyes caused by rheumatoid arthritis can be managed similar to chronic dry eye syndrome.