Systemic Lupus Erythematosus is a very complex disease that can affect multiple regions of the body, causing a wide range of symptoms. Although the systemic form of lupus can affect virtually any organ system of the human body, the disease commonly involves impairments of the eye. In patients with lupus, the ocular globe itself (eyeball) is affected more often than the ocular orbit (eye socket). When the ocular orbit is also affected, lupus leads to serious inflammation of the conjunctive membrane, soft tissue that covers the eyeball and interior lid. The lids may also become swollen and this type of ocular disease often involves the occurrence of local edema.
Lupus commonly determines the occurrence of “cotton wool spots” at the level of the retina. The spots are actually edematous regions of the retina, occurring as a result of inappropriate blood flow and thus, poor oxygenation of the eye. Despite the fact that the occurrence of “cotton wool spots” on the retina is not a direct indicator of lupus in middle-aged and older patients, it clearly reveals the presence of the disease in young patients. Other eye affections characteristic to lupus involve accumulation and deposition of fat cells at the level of the retina, decrease in the arteriolar blood flow and even pronounced obstruction of the eye blood vessels, which often determines loss of visual acuity or temporary blindness.
Patients diagnosed with systemic lupus are often confronted with keratoconjunctivitis sicca as well (also known as the dry eye syndrome), eye disorder that predominantly inflicts persons with autoimmune diseases. This type of eye disorder generates symptoms such as pronounced discomfort, inflammation, itching and burning at ocular level, and often leads to impairments of the lacrimal glands, resulting in decreased tears. On the premises of eye dryness and inappropriate blood circulation, the eye rapidly becomes inflamed and irritated, also increasing the risks of infections.
When keratoconjunctivitis sicca is accompanied by arthritis and symptoms such as dryness of the mucosal linings in the mouth and nose, the disease is referred to as Siogren’s Syndrome. When systemic lupus determines impairments at brain level, the disease causes deterioration of the optic nerve, nystagus (uncontrolled movements of the eye) and even complete blindness. In order to prevent the development of such complications and to reverse the effects of lupus at ocular level, it is imperative to administer the appropriate treatment as soon as possible.
Commonly used medications in treating the ocular complications produced by systemic lupus are salicylates (aspirin-based medications), antimalarials (commonly used medications include chloroquine-aralen, plaquenil and resochin), antibiotics and steroids. Steroid medications are extensively used in treating eye disorders characteristic to lupus, cortisone drugs being considered an efficient form of treatment at present. However, steroids can produce serious side-effects in patients with lupus, and thus such forms of treatment are not recommendable for long-term use.
