When people hear the word lupus, they usually think of joint pain, fatigue, or skin rashes. Few realise that the disease can also affect one of our most vital organs, the eye.
As ophthalmologists, we occasionally see patients whose first concern is not joint pain, but unexplained eye discomfort, blurred vision, or persistent dryness, only to later discover that these symptoms are linked to an underlying autoimmune condition such as lupus. This is why understanding the connection between lupus and eye health is so important.
Does lupus affect the eyes?
Lupus, medically known as Systemic Lupus Erythematosus (SLE), is an autoimmune disease in which the body's immune system mistakenly attacks its own tissues. Because the eyes contain delicate blood vessels, connective tissue, and nerves, they can become affected during inflammatory flare-ups. In many patients, the eyes may quietly reflect what is happening elsewhere in the body.
What are the common eye problems seen in lupus?
The most frequent complaint is dry eye disease. Patients often describe burning, irritation, redness, or a gritty sensation. This occurs because inflammation can disrupt the glands responsible for producing tears.
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Some patients may also develop light sensitivity, intermittent blurred vision, or eye fatigue that seems disproportionate to their daily activity.
Less commonly, but more seriously, lupus can cause inflammation of deeper eye structures such as the sclera (the white part of the eye), the retina, or even the optic nerve. These conditions can threaten vision if not diagnosed early.
What are the symptoms that should prompt an eye check-up
People living with lupus should not ignore:
*Persistent eye dryness or irritation
*Eye pain or redness
*Sudden blurred vision
*Increased sensitivity to light
*Floaters or dark spots in vision
*Double vision or partial loss of vision
*These symptoms may not always indicate a serious complication, but they should always be evaluated.
Can medications used for the treatment of lupus affect the eyes?
Yes, and this is an important part of long-term care.
Hydroxychloroquine, one of the most used medications for lupus, is highly effective and generally safe. However, with prolonged use, it can rarely affect the retina. The challenge is that early retinal toxicity is often silent, which is why baseline and periodic retinal screening are strongly recommended.
Long-term steroid use, another common part of lupus treatment, may also increase the risk of cataract and glaucoma in susceptible individuals.
Protecting your vision: What patients should do?
*Eye care should be considered a routine part of lupus management and not something reserved only for when symptoms appear.
*Regular annual eye examination or more frequent check-up when advised is essential. Patients should also stay hydrated, wear UV-protective sunglasses, and avoid self-medicating with over-the-counter eye drops without guidance.
*Most importantly, communication between the rheumatologist and ophthalmologist is key. Lupus is a systemic disease, and managing it well often requires a team approach.
Lupus can affect the eyes quietly, sometimes before patients even realise there is a problem. The good news is that with awareness, regular monitoring, and timely treatment, most vision-related complications can be identified early and managed effectively.
The author is a senior consultant ophthalmologist at Dr Agarwals Eye Hospital.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.