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Lupus and the Eye

The immune system protects the body from microorganisms such as bacteria and viruses, but in lupus its ability to distinguish between foreign material and its own tissues is defective. Inflammation follows immune attack on body tissues. At its onset, lupus may involve only one organ system. Lupus most commonly affects joints, the skin and the kidneys but the eye may also be involved. to antibodies and immune complexes damage tissues and cells. The cause of lupus is unknown.

Dry eye symptoms of discomfort, itching, gritty sensation and reflex watering may occur when the lacrimal glands that supply tears become involved. This may occur as part of Sjogren’s syndrome or sicca syndrome, where the salivary glands are also damaged, with dry eyes and a dry mouth. Symptoms are generally controlled with over-the-counter tear substitutes, control of ambient humidity, and barriers to evaporation of tears (glasses, side shields, goggles) and the loss of tears (minor lid surgery.) Although there is no specific treatment, there is a study on the use of cyclosporine in the treatment of dry eye. DHEA has also been the subject of investigation.

The skin around the eyes, including the eyelids, may be involved with the cutaneous changes of lupus. A rare but severe generalized skin eruption called erythema multiforme can occur. This causes severe inflammation of the conjunctiva that is the membrane that covers the sclera (white of the eye) and lines of the eyelids. Resultant scarring can lead to danger of exposure of the cornea (the clear window of the eye).

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Lupus and the Eye