9 Ways Lupus Can Affect Your Eyes & Vision

8 sources cited
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What is Lupus?

Lupus is an autoimmune disease. It attacks your body’s immune system, including the tissues and organs.3

There are four kinds of lupus. Some are more common than others:8

  1. Systemic lupus erythematosus (SLE). This is the most common type of lupus
  2. Cutaneous lupus. Cutaneous lupus is limited to the skin
  3. Drug-induced lupus. This kind is brought on by certain prescription drugs
  4. Neonatal lupus. Neonatal lupus is rare; it affects infants of mothers with lupus

(however, about 60% of women whose child has neonatal lupus may not have lupus themselves)

An estimated 161,000 people have systemic lupus erythematosus (SLE), and 322,000 have definite or probable SLE.4

Lupus can significantly affect your body in many ways, including your vision. Eye problems are a frequent side effect of the disease.3

Causes of Lupus

Lupus can affect anyone, but some people are more likely to develop it than others.

While scientists have not found genes that cause lupus, it does appear to run in families.6 If one identical twin has lupus, the other twin also has an increased chance of developing lupus.3

There are other factors that put some people at a boosted risk of developing lupus:

  • Sex. Lupus is more common in women by nearly 10 to one.3, 5
  • Age. The disease is most often diagnosed in people between the ages of 15 and 45.3
  • Race. African Americans, Hispanics, and Asian Americans are diagnosed with lupus more than other races.3

Certain infections, sun exposure, and even some drugs can trigger lupus:3

  • Antibiotics
  • Anti-seizure medications
  • Blood pressure medications

However, people with drug-induced lupus generally improve after taking medication.3 Hormonal or environmental triggers may also bring on lupus.8

Symptoms of Lupus

Lupus is different for everybody. The symptoms come on suddenly for some people and develop slowly for others. The condition also ranges in severity and may be temporary or permanent.3

Most people who develop lupus have mild cases characterized by episodes. These are called flares. They refer to symptoms that get worse for a while before improving or completely disappearing for spans of time.3

Sometimes, lupus can be difficult to diagnose. The symptoms of lupus may mimic other diseases and ailments.3

Lupus may cause inflammation of different parts of the body:3

  • Blood cells
  • Brain
  • Heart
  • Joints
  • Kidneys
  • Lungs
  • Skin

Other symptoms of lupus include the following:3

  • Facial rash across both cheeks and the bridge of the nose (it may take the shape of butterfly wings)
  • Rashes elsewhere on the body
  • Skin lesions that may appear or get worse in the sun
  • Toes that turn white or blue in the cold or while stressed
  • Fever
  • Fatigue
  • Shortness of breath
  • Pain in chest
  • Hair loss
  • Joint pain
  • Stiffness
  • Swelling
  • Headaches
  • Dizziness
  • Confusion
  • Behavioral changes
  • Memory loss
  • Strokes
  • Seizures
  • Kidney failure

Lupus can also affect your eyes and vision.3

9 Ways Lupus Can Affect Your Eyes and Vision

Here are some ways lupus can affect vision and eye health:

1. Retinal Vasculitis

People who have lupus may develop retinal vasculitis. This reduces blood supply to the retina.7

If your eye does not have enough blood supply, it will try to repair itself by forming new blood vessels. These can form in parts of the eye that might impair vision.7 The new blood cells can also bleed, which affects vision.7

Retinal vascular lesions are a common side effect of lupus. Approximately 28 percent of people hospitalized for lupus-related complications have lesions.2

2. Uveitis

Uveitis refers to uvea inflammation. The uvea is the vascular middle layer of the eye.7 If any eye layer becomes inflamed, it can cause vision problems.7

3. Conjunctivitis or Ulcers

Conjunctivitis is characterized by inflammation of the conjunctiva. This is the mucous membrane that protects the sclera (the white part of the eye). Inflammation of the blood vessels in the conjunctiva can cause redness, pain, and itching.7

People with lupus may develop conjunctival ulcers, which are uncommon.7

4. Discoid Lupus

Cutaneous lupus, which affects the skin, breaks down smaller subtypes. Discoid lupus is the most common kind.7

Discoid lupus can cause rashes and scars on the skin, including the eyelids. This subtype of the disease can also result in eyelash loss.7

5. Sjogren's Syndrome

Sjogren’s syndrome is an autoimmune disease that causes dry eye syndrome.7

Dry eye syndrome can occur when the lacrimal glands, which produce tears, become dysfunctional.7 It can feel like sand in the eyes.

About 20 percent of people who have lupus also have Sjogren’s syndrome.2

6. Scleritis

Scleritis refers to inflammation of the sclera. People who develop scleritis may notice yellow discoloration in the eyes.7 Scleritis can also affect the cornea in some cases.7

Approximately 1 percent of people who have lupus develop scleritis. It tends to be one of the first signs of the disease.2

7. Optic Nerve Damage

Lupus can also cause neuro-ophthalmic involvement, which is more commonly known as nerve damage

One to two percent of people with lupus also have lupus optic neuropathy. This can cause slow progressive vision loss.

8. Cranial Nerve Palsies

Cranial nerve palsies can lead to double vision. It may make eye movements and alignment, as well as pupil reflexes, poorer. This kind of nerve damage can also cause droopy eyelids.

9. Hallucinations

If lupus affects visual nerves in the brain, it can cause hallucinations. Visual nerve damage can also lead to peripheral or central vision loss.

When to See an Eye Doctor

You should see a doctor if your symptoms of lupus are not getting better with time, or if they are getting worse. 

Your doctor can help you treat the symptoms of lupus.

Lupus treatment consists of immunosuppressive drugs, like hydroxychloroquine and corticosteroids. These inhibit immune system activity.4

The FDA also approved belimumab in 2011. This is the first drug to treat SLE lupus in more than five decades.4

Outlook

There isn’t a cure for lupus. But treatments can help you keep your symptoms under control.3

Over time, lupus can take a toll on your health. It can severely affect the following organs long term:

  • Brain and central nervous system (CNS). If the brain is affected by lupus, it can contribute to all of the above symptoms, including vision problems.3
  • Blood and blood vessels. Lupus can reduce your blood’s healthy red blood cells, causing anemia and increasing the risk of bleeding and blood clotting.3
  • Kidneys. Kidney failure is a leading cause of death for people who have lupus.3
  • Lungs. Inflammation of the chest cavity lining and make breathing painful for people with lupus. Bleeding into lungs is also possible. People with lupus are at risk of developing pneumonia as well.3
  • Heart. Inflammation of the heart muscle, arteries, or membrane increases your risk of cardiovascular disease. People with lupus are at an increased risk for heart attacks.3

Lupus weakens the immune system, so people who have it are more vulnerable to infections. And because lupus affects blood flow, it can also lead to bone tissue death. Reduced blood supply to the bones can cause breaks.3

Lupus can also cause high blood pressure during pregnancy. Women with lupus who become pregnant have an increased risk of miscarriage.3

There is a very marginal increased risk of cancer for people who have lupus.3

Summary

Lupus can be a severe health concern, but it can also come and go. Keep an eye out for the signs and symptoms of lupus, and talk to your doctor if you have concerns.

If you develop lupus, consider the above treatment options to keep your symptoms under control.

8 Cited Research Articles
  1. Autoimmune Diseases: Clarity & Facts for Patients.” Autoimmune Diseases: Clarity & Facts for Patients - Autoimmune Disease  |  Johns Hopkins Pathology.
  2. How Lupus Affects The Eyes.” Lupus Foundation of America.
  3. Lupus.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 27 Jan. 2021.
  4. Systemic Lupus Erythematosus (SLE).” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 17 Oct. 2018.
  5. Systemic Lupus Erythematosus.” Mount Sinai Health System.
  6. Systemic Lupus Erythematosus: Medlineplus Genetics.” MedlinePlus, U.S. National Library of Medicine.
  7. What Eye Problems and Conditions Are Associated with Lupus?Hospital for Special Surgery.
  8. What Is Lupus?Lupus Foundation of America.
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