From the Guidelines
Several autoimmune diseases, including rheumatoid arthritis, Sjögren's syndrome, systemic lupus erythematosus (SLE), and inflammatory bowel disease (IBD), are associated with conjunctivitis, as they can cause the body's immune system to mistakenly attack the conjunctiva, leading to inflammation and other symptoms. These conditions can lead to autoimmune conjunctivitis, which requires addressing both the underlying autoimmune disease and the eye symptoms specifically 1.
Autoimmune Diseases Associated with Conjunctivitis
- Rheumatoid arthritis
- Sjögren's syndrome
- Systemic lupus erythematosus (SLE)
- Inflammatory bowel disease (IBD)
- Psoriatic arthritis
- Ankylosing spondylitis
- Multiple sclerosis
Treatment and Management
Treatment typically involves a combination of systemic treatments, such as immunosuppressants like methotrexate, biologics such as TNF inhibitors, or corticosteroids, and eye-specific symptoms, such as artificial tears for lubrication, topical cyclosporine (Restasis), or short courses of steroid eye drops like prednisolone acetate 1% 1. Patients should be aware that autoimmune conjunctivitis often recurs and requires ongoing management. The connection between these diseases and conjunctivitis stems from shared inflammatory pathways, with T-cells and inflammatory cytokines playing key roles in both the systemic disease and the ocular manifestations.
Importance of Early Detection and Treatment
Early detection and treatment of underlying systemic diseases, such as Sjögren's syndrome, can decrease morbidity and may even be lifesaving, as patients with Sjögren's syndrome are at increased risk for potentially life-threatening vasculitic or lymphoproliferative disorders 1. A recent study published in 2024 provides a comprehensive overview of conjunctivitis, including its classification, diagnosis, and treatment, and highlights the importance of differentiating between primary conjunctival disease and conditions in which conjunctival inflammation is secondary to systemic or ocular diseases 1.
From the Research
Autoimmune Diseases Associated with Conjunctivitis
- Rheumatoid arthritis (RA) 2, 3, 4, 5
- Systemic lupus erythematosus (SLE) 2, 6, 4, 5
- Sjögren's syndrome (SS) 2, 3, 6, 4, 5
- Systemic sclerosis 3, 6
- Giant cell arteritis 2, 6, 5
- Granulomatosis polyangiitis (GPA) 2
- Systemic vasculitis 2, 6
- Antiphospholipid syndrome (APS) 2
- Dermatomyositis 2
- Polymyositis 2
- Undifferentiated connective tissue disease 2
- Sarcoidosis 2
- Seronegative spondyloarthropathy 6, 5
- Multiple sclerosis 5
- Graves' disease 5