Can Rheumatoid Arthritis affect the eyes?

Question

My mother is 62 y.o and dx’d with RA with nodes on her fingers, and had a previous MRI noting disc dissecation in her L spine. Recently, she woke up with a detached retina, hemorroraging in her eyes and two large floaters. She has seen by her Internal, and and opthalmalagoist who told her they needed to wait for the hermorrhging to stop  but then they decided not to proceed with any surigical treatment. They gave her a new RX. She is in a lot of pain and her Internal is more concerned about addiction and not treating her pain. – She is still very active but i noticed she is getting very tired all the time. – Trying to find information about RA affecting the eyes is very slim. That is essentially what they told her is that the inflammation is causing her eye problems. That is fine and acceptable but I am trying to find someone who can give us not only a second opinion but a better idea of the severity of her dz. To boot she has GI problems, diverticulitis, IBS, and gastritis limits the types of medications she can use. My mother stated that two years ago the rheumatologist told her her condtion was not severe. They did offer her Humera shots or IV, is there not a tablet form of this medication? I want to make sure as her daughter that we take the best care of her and understand the severity of her condition and the “possible” course so we can be set to care for her in the upcoming years.

Answer

RA certainly can be associated with visual problems but a detatched retina is not typical. Inflammatory conditions involving the front part of the eye (episcleritis and iritis) are not uncommon in RA and in other forms of inflammatory arthritis.  Dry eyes (Sjogren’s) is frequently seen and can be severe in RA.  Some medications such as hydroxychloroquine (Plaquenil) and, chloroquine are sometimes also associated with visual complaints   It is important to be followed by an ophthalmologist. We generally recommend at least once a year.  Also she should be seen by a rheumatologist who can assist in her management sorting out which of her joint complaints may be RA and what may be degenerative disease.

Clifton Bingham, III, MD

About Clifton Bingham, III, MD

Associate Professor of Medicine
Director - Johns Hopkins Arthritis Center