Ocular manifestations in systemic lupus erythematosus
Journal Title: Medpulse International Journal of Ophthalmology - Year 2017, Vol 3, Issue 3
Abstract
Aim: To report the significance of ocular manifestations in Systemic lupus erythematosus Materials and methods: Seven diagnosed cases of Systemic lupus erythematosus, which included both newly diagnosed cases and cases already on treatment, were referred from the treating physician for ophthalmological evaluation. Comprehensive ophthalmic examination was done using BCVA, intraocular pressure measurement, Slit lamp examination of the anterior segment, fundus examination using Slit lamp biomicroscopy and indirect ophthalmoscopy, and Schirmers testing was done. In selected patients, certain special investigations like visual fields 24-2, 10-2 testing, SD-OCT was done. However ERG, couldnot be done due to lack of resource availability. Patients with history of Diabetes mellitus, Hypertension and other ophthalmic diseases like age related cataract were excluded. Results: Out of the seven cases of SLE examined, xerosis was the most commonly encountered manifestation, seen among 6 patients. Episcleritis was seen in one patient, Anterior uveitis seen in 2 patients, SLE associated retinopathy was seen in 3 patients. Treatment induced side effects like glaucoma was seen in 1 patient, posterior subcapsular opacities in 2 patients and Bull’s eye maculopathy suggestive of HCQ toxicity seen in 1 patient. While dryness, episcleritis and retinopathy were managed conservatively, Anterior uveitis was managed with topical steroids. Patients with HCQ associated toxicity were advised to stop the HCQ therapy or to go for an alternative regimen, those with posterior subcapsular opacities were advised cataract surgery, while glaucomatous patients were started on anti glaucoma therapy. Conclusion: Early diagnosis, prompt referral, coordinated treatment and long term follow-up through multi disciplinary approach involving Ophthalmologists, Rheumatologists and Dermatologist play a key role in reducing ocular and systemic morbidity associated with Systemic lupus erythematosus
Authors and Affiliations
Irfan Faraz, Vijaya Lakshmi B, Gopal Kishan M
Keywords
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