Rheumatoid arthritis is an autoimmune disease that is characterized by swelling of the tissues that lines the joints. This swelling can damage the bones and lead to problems like bone erosion or joint deformity. This disease isn't just a problem for your joints; your eyes may develop cataracts. Here are four things you need to know about this eye condition.
What are cataracts?
Cataracts are a sight-threatening eye condition: they're the leading cause of vision loss in America, and the leading cause of blindness throughout the world. They occur when the cornea, the clear tissue that covers your iris and pupil, becomes clouded and opaque. When this tissue becomes opaque, light can't pass through it, and your vision suffers.
If you develop cataracts, you'll notice changes in your vision like blurring or dimming. Since less light can enter your eyes, you'll find it more difficult to see at night or in dimly-lit environments.
How does rheumatoid arthritis cause cataracts?
Rheumatoid arthritis doesn't lead to cataracts on by itself; the issue lies with the drugs that are often used to treat it. Corticosteroids, a type of anti-inflammatory medication, are a common treatment for rheumatoid arthritis, but they can lead to serious eye complications, including cataracts.
Researchers have proposed multiple theories to explain how corticosteroids could lead to this complication. One of these theories is that the steroid molecules bond with particles in your lenses, forming opaque spots. Another theory is that the corticosteroids allow water to build up within your lenses, which allows proteins within the lenses to clump together. It's also been suggested that corticosteroids allow glucose to build up in your aqueous humor, the fluid behind your cornea, and cause cataracts in that way.
Since these theories aren't mutually exclusive, it's possible that corticosteroids cause cataracts for multiple reasons. Though the reasons are still up for debate, it's well-established in the medical literature that corticosteroids cause cataracts.
Are cataracts a common complication?
Cataracts are a fairly common complication of corticosteroid use. According to NIH, a number of studies have reported prevalence rates between 6.4% and 38.7%. The risk varies due to dosage as well as duration of usage.
The risk is higher for people who are taking high doses of the drug or who have been taking it for a long time; generally, doses of more than 10 mg per day for at least a year are associated with the development of cataracts. However, cataracts have been reported to develop in as little as two months in some cases.
Due to this risk, it's important to see your optometrist regularly for eye exams while you're taking corticosteroids. While the general rule is one eye exam per year, your optometrist may recommend more frequent screenings.
How are cataracts treated?
Cataracts don't go away by themselves, even if you stop taking the corticosteroids that caused them. To get rid of your cataracts, you'll need to have surgery. If you have cataracts in both eyes, one eye will be operated on first, and the other will be done one to three weeks later.
The procedure is simple and usually only takes 15 minutes. Your surgeon will use an ultrasound device to break your clouded cornea into smaller pieces. These small pieces will then be carefully removed through an incision in your eye. Once the entire cornea has been removed, an artificial lens will be inserted in its place.
If you're taking corticosteroids to control your rheumatoid arthritis symptoms, click here for info about eye exams. Ultimately, make sure to see your optometrist regularly for cataract screenings. If cataracts are discovered, they can be treated.
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