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The eye 

The eye
The eye
Oxford Textbook of Rheumatology (4 ed.)

Harry Petrushkin

and Miles Stanford

Previous versions of this chapter are available. To view earlier versions of this chapter view the full site here.

The ophthalmologist has a large part to play in the management of many rheumatological diseases. These diseases can cause a number of symptoms from mild ocular discomfort to sudden blindness. In addition, many rheumatological diseases have helpful ophthalmic signs, which can aid diagnosis. This chapter has been written to help rheumatologists identify these signs and symptoms. We have started by summarizing the common pathology found in patients with rheumatological diseases (dry eye syndromes, conjunctivitis, episcleritis, scleritis, uveitis, and optic neuropathy). This has been arranged working backwards from the front of the eye towards the retina and optic nerve. The rheumatological conditions that give rise to ophthalmic signs (giant cell arteritis, systemic lupus erythematosus, polyarteritis nodosa, Wegner’s granulomatosis, systemic sclerosis, rheumatoid arthritis, seronegative arthropathies, sarcoidosis, and Behçet’s disease) have then been summarized, including a section of paediatric conditions (juvenile idiopathic arthritis, spondyloarthropathies, and multisystemic illness). Finally, treatment regimes and recent guidelines have been covered for the screening of uveitis in juvenile idiopathic arthritis and the management of patients taking hydroxychloroquine. We hope that both rheumatologists in training and consultants find this chapter a useful clinical aid, and that it encourages them to look closely for subtle signs that will help improve the management of their patients.

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