How Ankylosing Spondylitis Affects Your Eye Health

If you have ankylosing spondylitis, be aware of the signs and symptoms of uveitis. It usually affects one eye at a time, but it can also affect both eyes. Uveitis can sometimes develop suddenly and progress quickly. Signs and symptoms may include redness, pain, sensitivity to light, blurry vision, and visual disturbances like dark spots.

If left untreated, uveitis can cause irreversible damage and vision loss. If you think you have uveitis, it is important to see your ophthalmologist immediately. The Mayo Clinic recommends bringing a list of questions with you to your eye exam so that you get the most out of your visit. Some questions include, what treatments are available, and which do you recommend?

A complete eye exam for uveitis may include a vision test, blood test, an examination of vitreous eye fluids, and eye-imaging tests. Your eye doctor will also gather a thorough medical history, so be sure to discuss any health problems and share your ankylosing spondylitis diagnosis.

The first line of treatment for uveitis is usually an anti-inflammatory eye drop, called a corticosteroid, that reduces swelling and pain. If eye drops are not effective, corticosteroids can be administered in the form of a pill or as an injection around your eye. Your doctor may also recommend eye drops that dilate your pupil, which can help to reduce pain and swelling.

A more recent development in uveitis treatment is the use of biologics — drugs made from human genes — to treat uveitis. Tumor necrosis alpha (TNF-α) blockers are types of biologic medications that are designed to suppress the molecules that cause inflammation in the eye. TNF-α blockers are available in the form of eye injections.

There are two surgical options for people with ankylosing spondylitis who have uveitis. The first is a procedure called vitrectomy that removes some of the vitreous humor — a clear, gel-like substance — from the eye cavity. Once the vitreous humor is removed, the surgeon has access to the retina and can perform additional repairs that may be necessary, such as removing scar tissue.

Another surgical procedure designed to treat uveitis involves a surgeon implanting a small, time-release capsule in your eye that slowly dispenses corticosteroid medication over the course of a predetermined time frame. It is an outpatient procedure, meaning you usually don’t have to be hospitalized and can go home the same day.

If uveitis is left untreated, many complications can ensue, including glaucoma, a disease that damages the eye’s optic nerve; cataract, a clouding of the eye’s lens; optic nerve damage caused by inflammation; retinal detachment, a medical emergency that occurs when the back of the eye pulls away from blood vessels that provide it with oxygen and nutrients; or vision loss.

Eye health is even more important for people suffering from uveitis. The National Eye Institute recommends simple tips for keeping your eyes healthy. If you have uveitis, contact your eye doctor right away if you experience any signs or symptoms, but also be diligent about scheduling an annual eye examination.

Research is constantly in progress to advance the diagnosis, treatment, and prevention of uveitis. In fact, the Ocular Immunology and Uveitis Foundation's explicit mission is to “find cures for ocular inflammatory diseases” and “provide education and emotional support for those patients afflicted with ocular inflammatory disease.”