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Ocular complications of rheumatic diseases

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Most of the inflammatory rheumatic diseases are systemic conditions with clinical and pathological manifestations outside of the joints. Many of the extra-articular manifestations of inflammatory rheumatic disease respond to the same treatments that target the joint disease itself, but some require specialised interventions. Ocular involvement is a common manifestation of inflammatory rheumatic disease and ranges from chronic troublesome symptoms, such as dry eye complicating Sjögren syndrome, to organ- and sight-threatening vasculitis. Isolated ocular abnormality has been reported to account for up to 4% of referrals to rheumatology clinics.1 Diagnosing and characterising serious ocular abnormalities are complicated by the need for specialised equipment and training — notably slit lamp and retinal examination — to fully assess eye disease. Consequently, it is incumbent on physicians involved in the care of patients with rheumatic disease to be aware of the potential ocular complications of their patients’ condition and the indications for rapid escalation of treatment to specialist level to preserve sight.

Here, we summarise these important conditions, in order of urgency of treatment, for non-ophthalmologists who are involved in the management of patients with rheumatic diseases (Appendix…