Dry eye in rheumatoid arthritis patients: Correlation with disease activity

Abstract

Introduction and Objectives: Dry eye is a very common disorder of tear film resulting from either decreased tear production or increased tear evaporation. Rheumatoid arthritis is a well-known risk factor for dry eye occurrence. This study was undertaken to assess dry eye prevalence in rheumatoid arthritis patients and assess its correlation with disease activity. Materials and Methods: The study period was one year. Seventy patients diagnosed to have rheumatoid arthritis were enrolled in this study. They were given an OSDI questionnaire, examined for signs of dry eye and subjected to four tests (Schirmer test, TBUT, rose bengal test, Impression cytology), based on which they were labelled as being positive or negative for dry eye. The arthritis disease activity was determined using DAS score. Results: Dry eye prevalence in rheumatoid arthritis was found to be 48.5%. OSDI scores were found to correlate well with diagnostic tests done for dry eye only when they were high indicating poor correlation between signs and symptoms in early stages. Prevalence increased with increase in age of patients. There was no correlation between the occurrence of dry eye and duration of rheumatoid arthritis, rheumatoid factor or arthritis disease activity. Conclusion: Prevalence of dry eye is high in rheumatoid arthritis patients. OSDI questionnaire is a useful screening tool for dry eye. Impression cytology is an easy and useful test to assess surface changes in dry eye patients. Keywords: Disease activity, Dry eye, Impression cytology, OSDI, Rheumatoid arthritis.