Exigency of ocular complications of systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) is an auto immune connective tissue disease which affects all organs in the body including eye. Ocular manifestations vary with underlying severity of the SLE had beed observed in 30% of cases. Ocular complications of SLE are commonly seen in advanced but uncontrolled and patients on irregular treatment. Keratoconjunctivitis sicca is the most common form of ocular complication of SLE, clinically manifests as dry eyes, lack of tear production which can be managed with artificial tear preparations. Clinical severity varies from mild asymptomatic red eyes and acute painful conjunctivitis, retrobulbar pain, orbital cellulitis, retinal artery occlusion and very severe cases leads to blindness which is often irreversible. Scleritis is an inflammatory complication of sclera which is as common as episcleritis in SLE. It can be classified in to anterior scleritis and posterior scleritis. Retinal involvement is a rare devastating complication of SLE. The prevalence of retinal disease in SLE accounts for 10% of cases. Mild forms of retinopathy are usually asymptomatic. In acute cases of SLE, the retinal changes manifests as defects in the visual field, distortion or floaters and sudden loss of vision. Anti-inflammatory agents, corticosteroids, anti-malarials play a major role in the management of long-standing complications of SLE. Immune complex deposition of antibodies against various structures of eye manifest differently. Early suspicion, prompt treatment, periodic monitoring of disease activity, early ophthalmic assessment of fundus, retina will bring down the incidence of SLE associated blindness. Early intervention of immune complex mediated Vasculitis involving eyes will prevent brain stem and central Nervous system (CNS) complications will bring down the mortality.