If you have arthritis, you are already familiar with this chronic disease that causes swelling and pain in parts of the body.
Everyone who has arthritis is susceptible to dry eyes.
Dry eyes can also become very painful and inflammatory for those people who suffer from autoimmune arthritis.
Dry skin may result in infections or scars to your eyes.
Can dry eyes cause eye pain?
Eye pain IS undoubtedly a symptom of dry eye.
The discomfort from dry eye can take the form of infrequent sharp pains in the eye or a more constant stinging, grittiness, or dull ache.
Other ocular manifestations include blurred vision, light sensitivity, gritty eye pain, and red eyes.
Why dry eyes in arthritis?
Dry eyes disease can happen when you don’t get enough lubricants in your eyes.
Can rheumatoid arthritis affect the eyes? Answer From April Chang-Miller, M.D. Rheumatoid arthritis is a chronic inflammatory disease that primarily affects the joints. However, rheumatoid arthritis occasionally affects other body parts, including the eyes.
Dry eyes are usually caused by decreased tear production or a lack of quality tear production. This tearing condition causes eye inflammation on the eye surface.
Dryness in the eyes is painful. Often your eyes will burn or sting when they get wet. Dry eyes can occur during travel on an airplane in air-conditioned rooms, on bikes, or on an electronic device. Dry eye care can increase your comfort.
A type of arthritis called RA damages the connective tissue covering the ends of joint bones. This connective tissue is made mainly of a substance called collagen. Collagen is also the primary substance of the eye’s sclera and cornea.
Rheumatoid arthritis is considered a disease of the entire body.
Rheumatoid arthritis may lead to dry eye, scleritis, Itchy eyes, blurry vision, mucus buildup, or sensitivity to light. These are some unpleasant symptoms of dry eye.
Learn how TheraLIfe can treat arthritis dry eyes.
Ocular involvement in systemic autoimmune diseases. Clinical Reviews in Allergy & Immunology . 2015; 49 (3):263–270. doi: 10.1007/s12016-015-8518-3. [ PubMed ] [ CrossRef ] [ Google Scholar
Watery dry eyes – tear over production.
Tear Quality:
Good tear quality is related to your tears’ mucin, water, and meibum ratio. If the ratio is imbalanced, your tears will not correctly lubricate your eye’s surface, leading to dry eye disease. Suppose the lacrimal gland (the gland that produces the water layer) is not producing enough aqueous. Health issues such as autoimmune disease (including rheumatoid arthritis) and inflammatory conditions can adversely affect this layer. In that case, the eyes can dry out very quickly.
Read more: Study of factors influencing dry eye in rheumatoid arthritis. ncbi.nlm.nih.gov/pmc/articles/PMC7429800 Schwartz TM, et al. (2016).
Statistics
The commoner form of inflammation is arthritis. Rheumatoid arthritis (RA) is a severe systemic autoimmune condition that consists of joint synovitis or multiple symmetric small or big joint eruptions. It has a prevalence of 0.017% in Asia and 0.33% globally in Europe, and 0.32% in China [ 1–5 ]. Nevertheless, in specific communities, like the Pima people in North America, this incidence could be between 2 %. Approximately 80% of the patients who suffer from RA have RA in their fourth and sixth decades of life.
Prevalence of Dry Eye Disease in Rheumatoid Arthritis Patients. Investigative Ophthalmology & Visual Science. June 2015.
Dry eyes disease can happen when you don’t get enough lubricants in your eyes.
We also called it to tear film instability. Normal tear production shuts down due to inflammation. When you have a dry eye disease, either you don’t make enough tears, or they evaporate too quickly. This may be due to age; your body produces fewer tears as you get older. Hormonal changes during pregnancy and menopause also play a role. So make a long list of medications, including antihistamines, decongestants, and birth control pills; your ability to produce enough tears can affect how quickly your tears evaporate.
Dry eyes are usually caused by not producing sufficient tears or a lack of quality tears. This tearing condition causes irritation on the eye surface. Dryness in the eyes is painful. Often your eyes will burn or sting when they get wet. Dry eyes can occur during travel on an airplane in air-conditioned rooms, on bikes, or on an electronic device. Dry eye care can increase your comfort.
Symptoms of dry eyes
Dry eyes are often accompanied by dry mouth and vaginal dryness.
Symptoms
- A stinging, burning, or scratchy sensation in your eyes.
- Stringy mucus in or around your eyes.
- Blurred vision
- light sensitivity
- Eye redness.
- A feeling of having something in your eyes.
- Difficulty wearing contact lenses.
- Problem with nighttime driving.
- Watery eyes are the body’s response to the irritation of dry eyes.
Causes of dry eyes in arthritis
Dry eye can have a variety of causes, from environmental factors to autoimmune disorders like rheumatoid arthritis. The reason for dry eye is that it disrupts the healthy tear film.
Fortunately, you can get treatment for dry eye, but you need to know whether it’s the result of an autoimmune imbalance.
Not all dry eye has the exact cause. See below
Common causes of decreased tear production include:
Aging
Certain medical conditions, including Sjogren’s syndrome,
allergic eye disease,
rheumatoid arthritis,
lupus,
scleroderma,
graft vs. host disease,
sarcoidosis,
thyroid disorders or
vitamin A deficiency
Certain medications, including antihistamines, decongestants, hormone replacement therapy, antidepressants, and drugs for high blood pressure, acne, birth control, and Parkinson’s disease Corneal.
An ocular manifestation of rheumatoid arthritis-different forms and frequency. ncbi.nlm.nih.gov/pmc/articles/PMC5489043
Treatment for dry eyes from arthritis and autoimmune diseases
If you experience dry eyes, you must consult your eye doctor or rheumatologist to get reassurance. It can be tough to self-treat your symptoms with eye drops because dry ocular manifestations can lead to severe complications.
Symptoms include dry eye, inflammation of joints, and a variety of other autoimmune conditions which cause additional eye issues.
Dry eye treatments include artificial tears, autologous blood serum drops,
Prevention
If the eye is dry and is prone to irritation, look for the conditions which can cause eye irritation. Find a way to avoid this situation to help you avoid dry eyes symptoms. Examples include: Avoid air blowing in your eyes. Don’t direct hair dryers, car heaters, air conditioners, or fans toward your eyes.
What is rheumatoid arthritis?
Rheumatoid arthritis (RA) is a chronic, progressive, and disabling autoimmune disease. It causes inflammation, swelling, and pain in and around the joints and can affect other body organs.
Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by joint synovitis and multiple symmetric small and large joint lesions. It is the most commonly observed type of inflammatory arthritis.
RA usually affects the hands and feet first, but it can occur in any joint. It usually involves the same joints on both sides of the body.
Symptoms
Common symptoms include stiff joints, especially when getting up in the morning or after sitting down for a while. Some people experience fatigue and a general feeling of being unwell.
The Rheumatoid Arthritis Support Network estimates that RA affects up to 1% of the world’s population and over 1.3 million people in the United States.
Other causes of dry eyes
1. Aging
Even though anyone can have dry eye, this condition becomes more common the older you get. Dry eye tends to affect people over 50Trusted Source because tear production declines with age.
This type of dry eye can’t be prevented. Still, regular artificial tears can provide extra lubrication to coat your eyes and relieve dryness.
2. Medication
Tears are composed of oil, water, and mucus. Certain medications, however, can reduce mucus production and contribute to chronic dry eye.
These include antihistamines, antidepressants, diuretics, and beta-blockers used to treat hypertension.
If you take a medication and experience eye dryness, talk to your doctor. Ask about an alternative medication or a lower dose to help reduce your dry eye.
You may also want to use artificial tears and your medication to keep your eyes lubricated.
3. Computer use
Some people who work on a computer experience eyestrain and tension headaches. In addition to these issues, staring at a computer can often affect your tears and lead to dry eyes.
This is because people who work at a computer monitor tend to blink less often. As a result, their tears evaporate more quickly.
Blinking will help lubricate your eyes. This can prevent dryness and irritation. If you use a computer for work, you can reduce dryness by blinking more frequently.
If you still experience dryness, use artificial tears while working at your computer. Additionally, give your eyes a break every now and then. Look away about every 20 minutes and repeatedly blink to re-wet your eyes.
4. Laser eye surgery
Some people begin to experience dry eyes after laser vision correction surgery. This procedure cuts some of the nerves in the cornea, causing the eyes to produce fewer tears.
This type of dry eye is usually temporary and resolves after a few days or weeks. Until your eyes heal, use lubricating eye drops to moisten your eyes.
5. Menopause
Hormones can play a role in dry eye. Some women experience dry eye symptoms during pregnancy, menopause, or while using birth control pills.
Hormones stimulate the production of tears, so an imbalance can reduce tear production.
Hormone replacement therapy doesn’t seem to improve dry eyes. But you can talk to your doctor about lubricating eye drops to reduce dryness and irritation.
6. Vitamin A deficiency
Vitamin A promotes healthy eyes. Foods rich in vitamin A include eggs, carrots, fish, spinach, broccoli, and peppers.
A diet low in foods that contain this vitamin can lead to dry eye and other vision impairments, such as night blindness.
A blood test can diagnose a vitamin A deficiency. You can also ask your doctor about using eye drops that contain vitamin A, although these aren’t commonly used for dry eye treatment.
7. Wind exposure
Cold climates and exposure to high winds can cause tears to evaporate too quickly, leading to chronic dryness.
To protect your eyes, use lubricating eye drops and wear sunglasses that wrap around your head to protect your eyes from cold and wind.
8. Sjögren’s syndrome
Sjögren’s syndrome is an autoimmune disorder that causes white blood cells to attack your salivary and tear glands, reducing tear production.
Treatment involves OTC and prescription lubricating eye drops. Your doctor may also prescribe a steroid eye drop.
When dry eyes don’t respond to eye drops, your eye doctor may recommend surgery that involves inserting silicone plugs into your tear ducts to help preserve some of your tears.
9. Other autoimmune conditions
In addition to other symptoms, many autoimmune conditions like arthritis, lupus, and diabetes can also cause poor or insufficient tear production.
Diagnosing and treating the underlying condition may help improve dry eye symptoms.
Treatment for an autoimmune condition can involve an immunosuppressant drug or a corticosteroid.
Diabetes involves managing your blood sugar with healthy lifestyle habits, diet, and medication.
10. Blepharitis
Blepharitis develops when small oil glands on your inner eyelid become clogged and inflamed. Along with dry eyes, you may have oily flakes around your eyelashes.
There’s no cure for this condition. Still, you can reduce inflammation by applying a warm compress over closed eyes for a couple of minutes and cleaning your eyelids with baby shampoo.
Until inflammation improves, use artificial tears to reduce dry eyes and redness. If your symptoms don’t improve, see your doctor and ask about treatment with antibiotic eye drops.
11. Allergies
Allergies can also trigger chronic dry eye. Your eyes may appear itchy, red, and watery. An oral antihistamine can reduce your allergies, although these medications can worsen dry eye symptoms.
If you only experience eye symptoms from allergies, ask your doctor about antihistamine eye drops.
12. Mild dehydration
Sometimes, dry eye results from dehydration or not drinking enough fluids. Other symptoms of dehydration include dark urine, lack of energy, dizziness, a rapid heartbeat, and not urinating.
Increasing your fluid intake and drinking more water can improve mild dehydration and ease chronic dry eye.
13. Low humidity
Dry air also contributes to dry eyes. This can happen if there’s low humidity in your home or if you sleep or work next to an air vent.
Moving your bed or desk so that air doesn’t blow directly on your eyes may improve symptoms. You may also want to use a humidifier to moisten the air and prevent tear evaporation.
14. Smoke
Smoking or exposure to secondhand smoke can also make your eyes dry.
Avoid smoky environments, and if you smoke, take steps to quit. Use nicotine replacement therapy or ask your doctor about a prescription medication to curb cravings.
15. Contact lens
Long-term use of contact lenses is another risk factor for chronic dry eye. This is because some contact lenses obstruct oxygen to the cornea.
If your eyes don’t receive enough lubrication, switch to eyeglasses and ask your eye doctor about contacts made explicitly for dry eyes. These lenses are designed to help your eyes retain moisture.
Dry eye diseases can make contact lens wear more difficult because contact lenses can irritate your eyes, making your dry eye disease symptoms worse and increasing your chances of developing an eye infection.
There are specialty lenses called scleral contact lenses that keep a reservoir to hydrate the eyes with a deficient tear film.
What is rheumatoid arthritis?
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RA is an autoimmune disorder. It occurs when a person’s immune system mistakes the body’s healthy tissues for foreign invaders. It is also a systemic disease that can affect the whole body.
As the immune system responds, inflammation occurs in the target tissue or organ. In the case of RA, this can be the joints, lungs, eyes, and heart.
Signs and symptoms
Signs and symptoms of RA usually occur in the wrists, hands, or feet and include:
- pain or achiness in more than one joint
- stiffness in more than one joint that lasts longer than 30 minutes
- swelling in more than one joint
- symmetrical joint involvement
- a general feeling of being unwell
- low-grade fever
- appetite loss
- weight loss
- weakness
- joint deformity
- loss of function and mobility
- unsteadiness when walking
According to the Centers for Disease Control and Prevention (CDC)Trusted Source, people do not typically receive a diagnosis of RA until they are in their 60s. Symptoms may start slowly and often get worse gradually over time.
People with RA usually experience periods when symptoms worsen, known as flares. RA symptoms may flare up due to stress, overactivity, or stopping medications.
Flares are followed by remissions when symptoms go away or are mild. Most people continue to experience flares and remissions throughout their lives.
RA usually affects the same joints on both sides of the body. Pain and stiffness tend to get worse after sleep or periods of inactivity.
Severe RA can lead to other complications throughout the body and cause joint damage that may lead to disability. Treatment can help manage the severity of symptoms and may reduce the likelihood of experiencing difficulties.
Dig into collective wisdom and support from our robust, free rheumatoid arthritis community. Tap into unlimited Bezzy RA articles.
Treatment
Suppose a person has a diagnosis of RA. In that case, the doctor may refer them to a specialist known as a rheumatologist, who will advise on treatment options.
Treatment will aim to:
- prevent flares and reduce their severity if they occur
- reduce inflammation in the joints
- relieve pain
- minimize any loss of function caused by pain, joint damage, or deformity
- slow down or prevent damage to the joints and organs
Options include medications, physical therapy, occupational therapy, counseling, and surgery.
Learn how TheraLife’s oral treatment for dry eyes.
Medications to manage symptoms
Some drugs can help to relieve symptoms and slow disease progression.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are available over the counter (OTC). Examples include Motril, Advil, and Aleve. Long-term use and high doses can lead to side effects. These include:
- bruising
- gastric ulcers
- high blood pressure
- kidney and liver problems
Corticosteroids reduce pain and inflammation and may help slow joint damage, but they cannot cure RA. If NSAIDs do not work, a doctor may inject a steroid into the joint. Relief is usually rapid, but the effect is variable. It can last a few weeks or months, depending on the severity of the symptoms.
Corticosteroids can help with acute symptoms or short-term flareups. However, a doctor will limit these injections to no more than three times per year because of their impact on the soft tissue structures in the joints. More frequent injections can potentially damage these structures or cause them to tear off where they attach to the bone.
Disease-modifying antirheumatic drugs (DMARDs)
The American College of Rheumatology (ACR) recommends treatment with disease‐modifying antirheumatic drugs (DMARDs), either alone or with other therapies, in people with moderate to severe RA. Methotrexate (Rheumatrex, Trexall) is an example of a DMARD.
DMARDs affect how the immune system works. They can slow the progression of RA and prevent permanent damage to the joints and other tissues by interfering with an overactive immune system. A person usually takes a DMARD for life.
These medications are most effective if a person uses them in the early stages of RA. Still, it can take several weeks to a couple of months to fully experience the benefits. Some people may have to try different DMARDs before finding the most suitable one.
Side effects can include:
- liver damage
- immune-related disorders
- increased risk of infections
- hair loss
- mouth ulcers
- nausea, stomach upset, and loose stool
- abnormal blood counts
Biologic treatments
Biologic treatments, such as tumor necrosis factor-alpha (TNF-alpha) inhibitors, also change how the immune system works. When the human body faces an infection or other threat, it produces TNF-alpha, an inflammatory substance. TNF-alpha inhibitors suppress this substance and help prevent inflammation.
TNF-alpha inhibitors can reduce pain, morning stiffness, and swollen or tender joints. People usually notice an improvement 2 weeks after starting treatment.
Examples include:
- adalimumab (Humira)
- certolizumab pegol (Cimzia)
- etanercept (Enbrel)
- golimumab (Simponi
- infliximab (Remicade)
Possible side effects
- a higher risk of infection
- lupus
- congestive heart failure
- demyelinating diseases, which damage the myelin sheath that normally protects nerve fibers
- lymphoma
- skin reactions
Occupational or physical therapy
An occupational therapist can help a person learn new and effective ways of carrying out daily tasks. For example, a person with painful fingers might learn to use a specially devised gripping and grabbing tool. This can minimize stress on painful joints.
A physical therapist can advise people about using assistive devices, such as a cane, and help individuals develop a suitable exercise plan.
Causes
Nobody knows what causes the immune system to malfunction, leading to RA.
Some people appear to have genetic factors that make developing RA more likely. One theory is that bacteria or a virus triggers RA in people who have this genetic feature.
In RA, the immune system’s antibodies attack the synovium, the smooth lining of a joint. When this happens, pain and inflammation result.
Inflammation causes the synovium to thicken. Eventually, if left untreated, it can invade and destroy cartilage — the connective tissue that cushions the ends of the bones.
The tendons and ligaments that hold the joint together can also weaken and stretch. The joint eventually loses its shape and configuration. The damage can be severe.
Rheumatoid arthritis vs. osteoarthritis
RA is an autoimmune disease that causes inflammation in the joints, leading to pain, stiffness, and swelling. Osteoarthritis leads same symptoms as RA but is due to normal wear and tear of the joints.
While RA usually affects the same joints on both sides of the body, osteoarthritis may only affect one side.
Although other symptoms can help a person figure out if they’re experiencing RA or osteoarthritis, only a doctor can diagnose them.
Diagnosis
It may be difficult for a doctor to diagnose RA early, as it can resemble other conditions.
The CDCTrusted Source recommends getting a diagnosis within 6 months of the onset of symptoms so that treatment can begin as soon as possible.
A doctor will look at the person’s clinical signs of inflammation and ask how long they have been there and how severe the symptoms are. They will also carry out a physical examination to check for swelling, functional limitations, or other unusual presentations.
They also may recommend some tests, including:
Blood tests
Some blood tests can help diagnose RA and rule out other conditions. They include:
- anti-cyclic citrullinated peptide (anti-CCP)
- rheumatoid factor
- erythrocyte sedimentation rate (ESR or sed rate)
- C-reactive protein (CRP)
Imaging scans and X-rays
An X-ray or MRI of a joint can help a doctor identify what type of arthritis is present and monitor the progress of RA over time.
Conditions with similar symptoms
The doctor will need to distinguish RA from other conditions with similar symptoms,
Learn about the differences and similarities between PsA and RA here.
Prevention
Researchers are looking at ways to prevent RA, but there is no specific way. They have been able to delay but not prevent the onset of RA.
Lifestyle practices that may help include:
- avoiding or quitting smoking
- following good hygiene practices to reduce the risk of infection, including good dental hygiene to prevent gum disease
- following a diet rich in fresh fruits and vegetables, which contain antioxidants
- Take eye breaks during long tasks. Take periodic eye breaks if you’re reading or doing another job that requires visual concentration. Close your eyes for a few minutes. Or repeatedly blink for a few seconds to help spread your tears evenly over your eyes.
Currently, smoking is the only lifestyle factor that appears to be strongly linked with RA.
See your ophthalmologist regularly or as they recommend to protect your sight. Don’t Let Arthritis Steal Your Vision! People with arthritis risk developing eye problems.
