Study of the Tear Film in Patients with Different Degrees of Rheumatoid Arthritis


The Department of Ophthalmology, Faculty of Medicine, Ain Shams University


Abstract Background: Rheumatoid arthritis (RA) is an autoimmune disease that affects mainly joints with extra-articular manifes-tations (e.g. neurological, pulmonary, cardiac), the most common of which is ocular manifestations which affect quality of life. Mechanism of dry eye in RA patients is not well understood and needs further studies. Aim of Study: The aim of this was to evaluate the tear film parameters in patients with different degrees of rheumatoid arthritis and compare them with healthy control group. Patient and Methods: Our study was a case-control study that was conducted on 64 patients (i.e. 128 eyes), divided into 2 equal groups (each group 32 patients , i.e. 64 eyes). Patients Group: Patients with rheumatoid arthritis. Control Group: Healthy controls. Both groups had no ophthalmological or physical disease causing dry eye. Results: This study found that prevalence of dry eye in RA patients is 46.7% according to schirmer test and 40.6% according to TBUT. Concerning healthy controls, prevalence of dry eye was 21.9% according to schirmer test and 18.8% according to TBUT. Ocular surface symptoms were present in all RA patients and in 50% of healthy controls. MGD (Meibomian gland dysfunction) was present in 53.1 % of RA patients and 9.4% of healthy controls. There was significant relation between RA activity and dry eye symptoms & MGD but no relation between RA activity and TBUT & schirmer test. Conclusion: Patients with RA have a significantly higher prevalence and severity of dry eye when compared to age-and sex-matched healthy controls. There was significant relation between the RA activity and ocular surface symptoms, MGD but no significant relation with TBUT, schirmer test. All RA patients should be always examined for dry eye regardless of disease activity.