Lupus can affect many parts of your body, including the eyes. It can cause skin problems around the eye and dry eye — and side effects from lupus medicines can sometimes cause eye problems too. Although lupus doesn’t usually cause serious vision loss, it can happen in rare cases. So make sure you get an eye exam every year to check for eye problems.
Skin problems around the eye
Most people with lupus have some form of cutaneous lupus, which can cause rashes and even scarring along the edge of the eyelids. When these skin problems happen around your eye, it can feel like your eyes are burning or itching. If you have scarring, it may be permanent — though scars may fade away over time or with treatment for some people.
Dry eye
About 1 in 5 people with lupus have dry eye. This usually happens because of a condition called secondary Sjogren’s syndrome, which makes it so the eyes can’t make enough tears. If you have dry eye, you may experience:
- Blurry vision
- Scratchy or burning feeling in your eyes
- Feeling like something is in your eyes
You can lessen dry eye symptoms by using a kind of eye drops called artificial tears. These can also help stop dry eye from damaging your eyes. You can usually get artificial tears over the counter at most pharmacies.
Side effects from lupus medicines
Some lupus medicines can cause eye problems, so make sure to tell your care team or eye doctor about any new symptoms you experience. It’s recommended that people with lupus get a comprehensive eye exam every year, especially if you take hydroxychloroquine (Plaquenil®). Rarely, this medicine can harm the eyes. If you’re taking hydroxychloroquine, your doctor can tell you how often you’ll need to get your eyes checked.
Steroid medicines can also raise the pressure inside the eye, which can lead to glaucoma — an eye condition that can cause vision loss and blindness. These medicines can also cause cataracts, cloudy areas in your eye that can lead to vision loss over time.
Other eye problems
Lupus often causes inflammation. Rarely, inflammation of the eyes can lead to vision loss. For example, lupus can cause:
- Retinal vascular lesions — changes to the blood vessels of the eye caused by too little blood flow
- Retinal vasculitis — inflammation in the blood vessels of the eye
- Scleritis — inflammation in the outer layer the eye (the white part)
- Uveitis — inflammation in the middle layer of the eye, like the iris (the colored part)
Lupus may also damage the optic nerve, which sends messages back and forth between the eye and the brain. Nerve damage is rare in people with lupus, but it can lead to serious vision loss. And if lupus affects the part of the brain related to your eyes, you may experience double vision, trouble moving your eyes, or droopy eyelids.
How to take care of your eye health
The most important thing you can do to take care of your eye health and protect your vision is to see an eye doctor every year. They can give you a comprehensive eye exam, which can catch eye problems early or before symptoms start — when most eye problems are easier to treat.
You may also need to see a special eye doctor called an ophthalmologist. Make sure you talk to your regular care team about your eye health — and let them know about any eye doctors you see for care. If you need help coordinating your care, reach out to your health care team— they may be able to connect you with a case manager or nurse who can assist.