From the Guidelines
Ulcerative colitis (UC) is commonly associated with several eye disorders, including episcleritis and uveitis, which are the most frequent ocular manifestations of the disease. These eye conditions occur due to shared inflammatory pathways between the gut and eyes, with immune dysregulation and circulating inflammatory mediators affecting both systems 1. The most common eye disorders associated with UC are:
- Episcleritis, which presents as painless redness of the eye and typically resolves on its own or improves when the underlying UC is treated
- Uveitis, inflammation of the middle layer of the eye, which presents with eye pain, light sensitivity, and blurred vision, requiring prompt ophthalmological evaluation and treatment with steroid eye drops like prednisolone acetate 1% every 1-2 hours initially, then tapered based on response 1. Patients with UC should have regular eye examinations, especially during disease flares or when experiencing eye symptoms, to prevent vision complications while managing the underlying inflammatory bowel disease. Prompt recognition and treatment of these eye conditions is essential, as uveitis has potentially more severe consequences, including progression to loss of vision, and should prompt urgent referral to an ophthalmologist 1.
From the Research
Eye Disorders Associated with Ulcerative Colitis (UC)
The following eye disorders have been associated with ulcerative colitis (UC):
- Anterior uveitis 2, 3, 4, 5
- Episcleritis 2, 3, 4, 5
- Scleritis 2, 4, 6
- Keratopathy 4
- Cataract 4
- Rhegmatogenous retinal detachment (RRD) 6
- Conjunctivitis 3
Prevalence of Ocular Lesions in UC Patients
Studies have reported the following prevalence of ocular lesions in UC patients:
- 18.75% of patients with moderate UC had ocular lesions, including episcleritis, keratopathy, uveitis, cataract, and scleritis 4
- 1% of patients with UC experience ocular complications, including anterior uveitis, episcleritis, and conjunctivitis 3
Treatment and Management of Ocular Disorders in UC
Treatment and management of ocular disorders in UC patients may involve: