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Rheumatology Advance Access originally published online on August 5, 2007
Rheumatology 2007 46(12):1757-1762; doi:10.1093/rheumatology/kem173
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

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Ocular manifestations of systemic lupus erythematosus

R. R. Sivaraj1, O. M. Durrani1, A. K. Denniston1, P. I. Murray1 and Caroline Gordon2

1Academic Unit of Ophthalmology and 2Department of Rheumatology, Division of Immunity and Infection, University of Birmingham, UK.

Correspondence to: C. Gordon, Rheumatology (East Wing), Division of Immunity and Infection, The Medical School, University of Birmingham, Vincent Drive, Birmingham B18 7QU, UK. E-mail: p.c.gordon{at}bham.ac.uk


  Abstract

Ocular manifestations of lupus are fairly common, may be the presenting feature of the disease and can be sight-threatening. Almost any part of the eye and visual pathway can be affected by inflammatory or thrombotic processes. Ocular pain and visual impairment require urgent assessment by an ophthalmologist. Infection should be excluded. Optic neuritis and ischaemic optic neuropathy may be difficult to distinguish. Scleritis and severe retinopathy require systemic immunosuppression but episcleritis, anterior uveitis and dry eyes can usually be managed with local eye drops. Vaso-occlusive disease, particularly in the presence of antiphospholipid antibodies, requires treatment with anticoagulation and proliferative retinopathy is treated with laser therapy. Hydroxychloroquine rarely causes ocular toxicity at doses under 6.5mg/kg/day. When this has occurred, it has been associated with more than 5 years of drug exposure.

KEY WORDS: Lupus, Ocular, Ophthalmic, Retinal, Scleral, Corneal, Optic

Submitted 12 January 2007; revised version accepted 25 May 2007.
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