Aim of the workThe aim of the present work was to present the frequency of ocular surface manifestations in rheumatoid arthritis (RA) patients and to determine its correlation with disease activity and duration. Patients and methodsThis cross-sectional study included 70 RA patients. Disease activity score (DAS-28) was scored. All patients underwent complete ophthalmic evaluation including assessment of visual acuity. Ocular surface assessment by Rose Bengal (RB) stain, and Schirmer test (ST) was carried out. ResultsSeventy patients (137 eyes) were studied; 3 eyes were excluded due to previous eye surgery. Patients were 67 women and 3 men with a mean age of 47.96 ± 10.8 years, and disease duration 9.19 ± 6.26 years. The mean DAS28 was 4.1 ± 0.77. Rheumatoid factor was positive in 39 (55.7%). Mean best-corrected visual acuity was 0.47 ± 0.33, ST was 10.6 ± 6.1 mm/5 min and RB score was 6.8 ± 3.6. 70% had ocular manifestations in the form of dry eye (54.7%), pterygium (16.1%), posterior blepharitis (5.8%), scleritis (1.3%), corneal thinning (13.9%), filamentary keratitis (8.7%) and maculopathy (11.7%). There was a significant correlation between ST and disease duration (r = −0.17, p = 0.04). Morning stiffness had a significant correlation with both ST (r = −0.2, p = 0.02) and RB (r = 0.22, p = 0.01) and remained significant on regression analysis. DAS-28 was not significantly associated with any of the ocular surface abnormalities. ConclusionOcular manifestations are significant in patients with RA. The most common ocular manifestation is dry eye. Ocular manifestations are significantly associated with the disease duration and should be expected regardless of disease activity in RA patients.