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Rheumatoid arthritis (RA) is a type of autoimmune disease. In this disease, your body's immune system mistakenly attacks your joints, which leads to pain and swelling, and eventually, joint damage. However, RA isn't just a joint disease; it can damage a variety of tissues, including your eyes. One of the eye issues you may develop is corneal melt; here are four things you need to know about it.
What is corneal melt?
The cornea is the clear tissue that covers your pupil and iris. Its job is to protect the tissues beneath it, as well as to refract light as it enters your eye. Corneal melt is a serious disorder of this tissue.
In people with corneal melt, the tissue that connects the cornea to the white of the eye tears. This tear allows the iris to slip out from beneath the cornea. If you develop this condition, you'll notice that your pupils have become irregularly-shaped instead of round.
How does RA cause corneal melt?
Like other complications of RA, high inflammation levels are responsible for causing corneal melt. When your immune system attacks the sclera, the white part of your eye, it causes inflammation. This inflammation allows the sclera and the cornea to pull apart.
How serious is it?
One possible complication of corneal melt is perforation of the cornea, meaning that a hole forms in the cornea. This hole allows bacteria to get inside your eye, which can lead to infections. The damage to the cornea can also lead to decreased vision or a complete loss of vision.
Corneal melt is also a sign of more serious problems within the body. According to the Oxford Journal of Rheumatology, more than half of rheumatoid arthritis patients with corneal melt will later develop systemic vasculitis. Vasculitis is an inflammation of your blood vessels, and this inflammation restricts blood flow throughout your body and damages your tissues.
How is it treated?
Due to the severity of this condition and its connection with systemic vasculitis, your optometrist and rheumatologist will need to work together to treat you. After consulting together, your doctors may choose treatments like bandage contact lenses. These lenses hold your cornea in place while it heals. Eye-safe glue can also be used for this purpose.
Controlling inflammation is also essential, both for healing your cornea and for preventing systemic vasculitis. Your doctors may use medications like corticosteroids to get your inflammation levels under control.
If you have rheumatoid arthritis and notice any change in the shape of your pupils, see your optometrist immediately.