Rheumatoid Arthritis and Chronic Dry Eye

Recent studies have estimated that nearly 16.5 million adults in the United States have been diagnosed with chronic dry eye. About 6 million more people have symptoms of the disorder, but they have not been diagnosed with chronic dry eye.1

Doctors think chronic dry eye is caused by irritation or inflammation of the surface of the eye. This irritation occurs because there is not enough lubrication on the eye.1

Like dry eye disease, rheumatoid arthritis (RA) is a common health problem. RA is a chronic disease that causes joint inflammation, pain, stiffness, and swelling. RA commonly occurs with chronic dry eye.1

What is rheumatoid arthritis?

RA is 1 of more than 100 different types of arthritis. By 2040, more than 1 in 4 adults in the United States will be diagnosed with some type of arthritis.2

RA is an autoimmune and inflammatory disease. Autoimmune diseases or conditions may occur when your immune system attacks healthy cells in your body by mistake. This causes inflammation (painful swelling) in the affected parts of your body. RA is mainly considered a joint disease, but RA often impacts multiple organs (called extra-articular symptoms) because of the abnormal immune response that happens with RA.3,4

What is a comorbid condition?

Doctors use the term comorbidity to describe a condition or illness that occurs at the same time as another condition or illness. Comorbid illnesses can interact in ways that worsen 1 or both conditions. Morbidity should not be confused with the term mortality. Morbidity means disease or illness, and mortality means death. RA is a comorbid condition of chronic dry eye.5

What happens in RA that leads to dry eye disease?

Doctors are still studying the reasons why RA may lead to dry eye disease. Rheumatoid factor (RF) is a protein that is made by your immune system. High levels of RF are linked to various autoimmune diseases, including rheumatoid arthritis. However, high levels can occur in someone without autoimmune disease. On the other hand, someone with an autoimmune disease may not have high levels of RF.6

Recent studies have shown that RA and chronic dry eye can develop in similar ways. Both RA and dry eye disease can affect the mucus membranes of the body. Depending on the areas of the body affected, your symptoms may look different. For example, the mucus layer of the tears that coat your eye may be impacted by RA and cause dry eye disease. RA may also be linked to secondary Sjögren’s syndrome, which causes dry eyes and dry mouth.6

Because dry eye disease and RA may occur together, you may think that dry eye symptoms will worsen if RA symptoms are worse. This is not always the case. RA disease activity may not worsen dry eye symptoms. This adds to the complex nature of both diseases, making both that much more difficult to diagnose.6

How is dry eye disease treated?

Treatment of dry eye disease is often the same in those with or without RA. Treatment of dry eyes first includes finding the cause of the problem. If you have learned that your dry eye disease symptoms are likely due to RA, your doctor will treat your symptoms based on your personal health history and disease progression.1

Treatment for dry eye disease includes medicines and therapies designed to increase tear production, improve the tear quality, or restore the surface of the eye. Talk to your doctor if you are having dry eye symptoms.1

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Written by: Katie Murphy │ Last reviewed: June 2021