Eye disease occurs in approximately
20 percent of patients with SLE. In
some cases, eye problems are related
to the inflammatory process of lupus
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
- 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
- Uveitis (inflammation of the
iris, ciliary body, vitreous gel
and/or choroid) and scleritis
may be part of the systemic
inflammatory process of the
- 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
- 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
2. visual impairment
3. potential for injury
4. difficulty carrying out activities
of daily living
Objective: Minimize discomfort.
1. Allow time for the patient
to express concerns and ask
2. Teach the patient how to apply
artificial tears for dry eyes to
increase comfort and prevent
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
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