RA and Eye Health: What You Can’t See Can Hurt You

Leslie Rott Health Guide
  • I went to the eye doctor recently.


    When I last saw my primary care doctor, she asked if I was going to the eye doctor yearly. 


    I admitted that while I know I’m supposed to, I haven’t, for several reasons.


    First, I think I get a bit of appointment fatigue, and the thought of having one more appointment that seems like it isn’t absolutely necessary is a good way to talk myself into not doing it.


    Second, my eye doctor is where my parents live.  He saw me when I was born, in the hospital as a two-pound premie, and I have been going to him ever since.  But when I am delinquent on appointments, his office sends me nasty grams.  Another great way to get me to avoid making an appointment.  Maybe these notes should have the opposite effect, but there you go.

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    Third, every time I go to the eye doctor, he is very judgmental about the medications that I am on.  This is very frustrating.  My mom thinks he is just old school, but I don’t really think it’s his place to evaluate that, unless my medications are having some kind of negative effect on my eyes.  So I avoid going because I loathe the lectures that are going to ensue. 


    So those are my excuses.


    My primary care doctor wasn’t so happy to hear that I haven’t been keeping up with my yearly eye doctor appointments, so she did refer me to an eye doctor within the health system that is close to me.


    I went.  And they were very thorough.  They did the normal eye tests and took pictures of my eyes.  Everything turned out fine, other than the fact that my eye glass prescription changed one full point in one eye, and one and a half points in the other.  I guess that’s what happens when I spend countless hours a day in front of my computer, writing a dissertation (and not going to the eye doctor for two and a half years).


    So I guess I need new glasses.  I am severely nearsighted and have been since I was in late elementary school, although I avoided wearing glasses full time for as long as I possibly could.


    Because of what my new glasses cost me, I am telling myself that I won’t go to the eye doctor for another two years.


    I know.  Not the best philosophy when I know I should be going yearly.


    But eyes are a funny thing in that if you can see and don’t have any other eye problems, you don’t have to see an eye doctor.  But for people with RA, even if you haven’t experienced troubled vision before, if you are on certain medications, it becomes necessary to get your eyes checked yearly to make sure the medication isn’t causing toxicity that could permanently damage your eyes.

    Long-term steroid (such as prednisone) use can cause cataracts – a clouding of the lens of the eye – and glaucoma – damage to the optic nerve, causing a variety of problems – and anti-malarial medications (such as Hydroxychloroquine/Plaquenil) can cause maculopathy – illness to the macula – the center of the retina at the back of the eye (Piper, et al. 2007).


  • Other negative impacts of visual impairment that can impact people with RA include falls and improper medication administration (Piper et al. 2007).

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    Many people with RA have a secondary condition, Sjogren ’s syndrome, which among other things, can cause dry eyes, often requiring the use of artificial tears or prescription eye drops.  I have this and use artificial tears to keep my eyes lubricated.


    Lisa Emrich has previously written a very informative piece about RA and eye health, and the problems that RA can cause in the eyes.  See “Rheumatoid Arthritis and Eye Health:  Complications to Watch Out For”.  Given this, I opted to focus more on the medication and other issues that can come with RA and the eyes.




    Piper, H., K.M. Douglas, G.J. Treharne, D.L. Mitton, S. Haider, and G.D. Kitas. 2007. “Prevalence and Predictors of Ocular Manifestations of RA: Is There a Need for Routine Screening?” Musculoskeletal Care 5 (2): 102-117.



Published On: July 30, 2013