Eye inflammation can occur for a number of reasons — from injuries and irritation to infection. It can also be an indicator of a much broader condition that affects a number of organs in the body, such as an autoimmune disease.
To help you understand this link a little better, we’ll take a closer look at when eye inflammation can be a sign of an autoimmune disease, and the different conditions it can be used to detect.

What is an autoimmune disease?

Autoimmune diseases are conditions in which the immune system, that typically guards against germs, can no longer tell the difference between foreign viruses or bacteria and the body’s own cells. This causes the immune system to mistakenly attack the normal cells in the body, leading to a number of symptoms from fatigue to digestive issues and inflammation.

Can autoimmune diseases cause eye problems?

An autoimmune disease can affect any part of the body, including the eyes. Some autoimmune conditions specifically impact the eyes, at the front on the clear structure called the cornea, such as a Mooren’s corneal ulcer and some in the middle and back of the eye such as uveitis.1 However, eye inflammation can also be a symptom of a much broader autoimmune diseases that affect more than one body part such as in rheumatoid arthritis, Sjogren’s syndrome, multiple sclerosis, and Reiter’s Disease.2 

As a result, autoimmune diseases can cause a number of signs and symptoms, from double vision and drooping eyelids to inflammation.

Which autoimmune eye diseases can be spotted through eye inflammation?

Rheumatoid arthritis

The eye is composed of tissues that are similar to joints.3 As a result, many autoimmune diseases that affect joints also affect the eyes — such as rheumatoid arthritis. The most common eye-related symptom of rheumatoid arthritis is dryness, although more severe cases can cause inflammation in the white part (sclera) of your eyes, leading to scleritis.

Sjogren’s syndrome 

Sjogren's syndrome is a chronic autoimmune disease that attacks the glands responsible for keeping the eyes, mouth and other parts of the body moist and lubricated. One impact of this is called meibomian gland dysfunction — a condition where the glands in the eyelids that secrete oil (meibum) to keep your eyes lubricated become inflamed and obstructed. When diagnosing Sjogren's syndrome, ophthalmologists will look out for signs of severe dry eye syndrome, alongside blocked, inflamed glands.4 

Bechet’s disease

This is a systemic autoimmune disease that causes blood vessel inflammation throughout the body — including the eyes. Approximately 70% of patients with Bechet’s disease will experience eye inflammation symptoms such as uveitis and retinal vasculitis (inflammation of the retinal blood vessels).5

Graves' disease

Graves’ disease is a condition in which the immune system attacks the thyroid gland, leading to an overproduction of thyroid hormones. This has a number of effects on various parts of the body, including the eyes. Around 30% of patients with Graves’ disease show signs of Graves’ ophthalmology — the inflammation of muscles and tissues around the eyes which can result in bulging, puffy eyes.6

Multiple sclerosis

Multiple sclerosis (MS) is an autoimmune disease that affects the brain, spinal cord and optic nerve. Optic neuritis (inflammation of the optic nerve in the eye) is a common symptom of MS, and is typically one of the first signs of MS, which can be detected by an OCT scan. 

Those affected by optic neuritis usually experience symptoms in just one eye.7 Other eye symptoms associated with MS include nystagmus (rapid, uncontrolled movement of the eyes) and diplopia (double vision).7

Reiter’s syndrome

Reiter’s syndrome (also known as reactive arthritis) is a type of inflammatory arthritis that affects the joints, eyes, and urethra. Eye inflammation is a common symptom of Reiter’s syndrome, which can occur in the form of conjunctivitis and uveitis (inflammation of the middle layer of the eye).8  

Sarcoidosis

Sarcoidosis is a rare condition that causes small patches of red and swollen tissue, called granulomas, to develop in the organs of the body. It usually affects the lungs, skin and eyes. Sarcoidosis can affect people of any age, but usually starts in adults aged between 20 and 40. Sarcoidosis can occasionally occur in more than one family member, but there's no evidence that the condition is inherited.9 The condition isn't infectious, so it can't be passed from person to person.

How can an eye test help spot signs of autoimmune eye conditions?

We recommend that you have a routine eye test at least every two years in order to monitor your eye health over time. However, if you are concerned about any changes in your vision, or notice symptoms like those mentioned above, it’s important to book an eye test to have them checked out. Your optometrist can conduct a number of different tests to spot any signs of an autoimmune eye condition, such as double vision and inflammation, and decide on the best treatment option for you.

OCT scans

One test that your optometrist might conduct is an optical coherence tomography scan (commonly known as OCT scans). OCT scanning allows us to see what’s going on beneath the surface of the eye, which may be useful for detecting conditions — including autoimmune eye diseases — that don’t have many noticeable symptoms in the early stages. 

Since many of these conditions form at the back or in the middle of the eye, OCT technology can help your optometrist to spot early signs and symptoms of these conditions, before they begin to impact your vision. This means that conditions such as autoimmune eye diseases can be managed before they get worse and can help prevent potential sight loss. 

Want to learn more about OCT scanning? Visit our OCT scan resource or book an appointment with a Specsavers optician to find out more autoimmune eye diseases and their diagnosis.

References

1. The Ocular Immunology and Uveitis Foundation. (no date). Ocular Autoimmune Disease: An Introduction. [Online]. Available at: https://uveitis.org/patient_articles/ocular-autoimmune-disease-introduction/ [Accessed 20 November 2019].

2. E-medicine Health. (no date). What Autoimmune Diseases Affect the Eyes? [Online]. Available at: https://www.emedicinehealth.com/ask_what_autoimmune_diseases_affect_the_eyes/article_em.htm#ask_a_doctor [Accessed 20 November 2019].

3. The Ocular Immunology and Uveitis Foundation. (no date). Connection Between Arthritis and Ocular Disease. [Online]. Available at: https://uveitis.org/connection-arthritis-ocular-disease/ [Accessed 20 November 2019].

4. Healio. (no date). Factors separate Sjogren’s syndrome from simple dry eye. [Online]. Available at: https://www.healio.com/ophthalmology/news/print/ocular-surgery-news-europe-asia-edition/%7B1a8b3144-7978-4b38-8968-9e65574acf00%7D/factors-separate-sjgrens-syndrome-from-simple-dry-eye [Accessed 20 November 2019].

5. American Academy of Ophthalmology. (no date). Behcet’s Disease. [Online]. Available at: https://eyewiki.aao.org/Behcet%27s_Disease [Accessed 20 November 2019].

6. Bausch and Lomb. (no date). Graves’ Disease (Graves’ Ophthalmopathy). [Online]. Available at: https://www.bausch.com/your-eye-concerns/chronic-conditions/graves-disease [Accessed 20 November 2019].

7. National Multiple Sclerosis Society. (no date). Vision Problems. [Online]. Available at: https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms/Vision-Problems [Accessed 20 November 2019].

8. Kovalev IuN, II’in II. Ophthalmological aspects of Reiter’s disease. Vestn Oftalmol. 1990 Jul-Aug;106(4):65–9. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pubmed/2238333 [Accessed 20 November 2019].

9. NHS UK. (2018) Sarcoidosis. [Online]. Available at: https://www.nhs.uk/conditions/sarcoidosis/ [Accessed 22 January 2020]