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Narrative review

Ocular complications of rheumatic diseases

Colby Hart, Merv Ferdinands and Leslie Barnsley
Med J Aust 2017; 206 (5): 224-228.
doi:
10.5694/mja16.00352
Summary

  • Rheumatic diseases are frequently complicated by extra-articular manifestations, often affecting the eye.
  • Most of these ocular symptoms are benign and develop over long periods of time.
  • Some ocular complications of rheumatic disease or the drugs used to treat the disease are rapidly sight-threatening.
  • It is vital that sight-threatening complications are recognised quickly, so that appropriate diagnostic and therapeutic procedures, such as slit lamp examination and the initiation of immunosuppressive treatments, can occur in a timely fashion.
  • Insight into the epidemiology, clinical presentation, common complications and treatment regimens of these ocular manifestations enables early detection and may prevent permanent loss of vision.

Most of the inflammatory rheumatic diseases are systemic conditions with clinical and pathological manifestations outside of the joints. Many of the extra-articular manifestations of inflammatory rheumatic disease respond to the same treatments that target the joint disease itself, but some require specialised interventions. Ocular involvement is a common manifestation of inflammatory rheumatic disease and ranges from chronic troublesome symptoms, such as dry eye complicating Sjögren syndrome, to organ- and sight-threatening vasculitis.

Colby Hart1
Merv Ferdinands2
Leslie Barnsley3
1 Alfred Health, Melbourne, VIC
2 Ophthalmology, Barwon Health, Geelong, VIC
3 Rheumatology, Concord Repatriation General Hospital, Sydney, NSW
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