Overview

Eye disease occurs in approximately 20 percent of patients with SLE. In some cases, eye problems are related to the inflammatory process of lupus itself.

In other cases problems may be due to drug treatment (corticosteroids or antimalarials) or may be a separate problem (glaucoma or retinal detachment). Blindness due to SLE occurs, but is rare.

Potential Ophthalmologic Manifestations A lupus rash may develop on the eyelids. Kerato-conjunctivitis is "dry eye" related to Sjogren's syndrome. Some people with lupus have Sjogren's syndrome, which is an autoimmune condition that causes excessive dryness of the mucous membranes. People with lupus who have these symptoms require artificial tears to relieve dry eyes. Uveitis (inflammation of the iris, ciliary body, vitreous gel and/or choroid) and scleritis may be part of the systemic inflammatory process of the disease. Cytoid bodies are the most common retinal change in SLE. They reflect microangiopathy of the retinal capillaries and localized microinfarction of the superficial nerve fiber layers of the retina. Glaucoma and cataracts may be caused by corticosteroids. Antimalarials can damage the retina, which can impair vision (particularly color vision) or, extremely rarely, cause blindness. The risk of retinopathy is as low as 1 in 5,000.

Potential Problems

1. discomfort

2. visual impairment

3. potential for injury

4. difficulty carrying out activities of daily living

Nursing Interventions

Objective: Minimize discomfort.

1. Allow time for the patient to express concerns and ask questions.

2. Teach the patient how to apply artificial tears for dry eyes to increase comfort and prevent corneal abrasion.

3. Teach the patient the correct way to take prescribed medications, such as eye drops for glaucoma.

Objective: Minimize potential for serious visual impairment or blindness.

1. Assess the patient's vision changes and impairments.

2. Reinforce the need to follow up with an ophthalmologist.

Objective: Develop a plan for patient to perform ADL appropriately and independently.

1. Provide referrals to support groups and services for the visually impaired.

2. Refer to the CNS lupus nursing interventions for additional suggestions.

Objective: Minimize potential for injury.

1. See the CNS lupus nursing interventions for suggestions.

Note: For additional information, see the Patient Information Sheets on Living With Lupus and Serious Conditions Associated With Lupus.



Source: National Institutes of Health, U.S.Dept of Health and Human Services