Background: Rheumatoid Arthritis (RA) is an auto Immune chronic Inflammatory disorder of worldwide distribution and it causes painful and destructing articular conditions.  Extra articular manifestation in RA are more common in sero +ve patients.  The extra articular manifestations includes, epicarditis, pleuritis, major cutaneous, vasculitis, ophthalmic manifestations, glomerulo nephritis, and other type of vasculitis. Ophthalmic manifestation caused by RA causes severe ocular morbidities if not screened at an early stage.

Materials and Methods: A hospital based prospective observational study on patient attended at Rheumatology Department of Medical College, Thiruvananthapuram who have diagnosed as Rheumatoid arthritis were examined and called for detailed ocular evaluation at RIO Clinic.  A total of 198 cases were screened during August 2019 to January 2021.  All patients were subjected to detailed history, pertaining to age, duration of the disease systemic manifestation of RA, drug history and its duration and symptoms related to ophthalmic manifestation were collected. Protocol based treatment were offered after detailed ophthalmic evaluations tests and effect of treatment was studied during follow up periods.  Data of the patients were recorded on a pre-fabricated proforma.  Data was statistically analysed by chi-square analysis odds ratio and Logistic regression analysis.

Results: 115 (58.08%) patients of RA (Rheumatoid arthritis) showed Ophthalmic manifestations KCS. (dry eye manifestations) was the most common complications which responds well to artificial tear substitutes on daily application. Complications like episcleritis scleritis and iridocyclitis and keratitis were noted out and active emergency strategies were given to avoid ophthalmic morbidities and this helped to alleviate the problems of severe Vn Impairment.  Drugs related to ocular complications like quinolen toxicity and posterior sub capsular opacity due to steroid toxicity were ruled out and strict follow up measures were given along with the guidance of the Rheumatologist.

Conclusion

1. Rheumatoid arthritis is also a systemic auto immune disease have signs and symptoms of the eye.
2. KCS (Dry Eye manifestation) were the commonest complication.
3. Early Ophthalmolgic interference and active treatment regimen can reduce further extent of ocular morbidities and thus Vn threatening conditions.

Keywords: Rheumatoid arthritis, peripheral Ulcerative keratitis, hydroxy- chloroquine, kerato conjunctivitis sicca, Non steroidal anti inflammatory drugs, posterior sub capsular cataract.

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S Rema Devi

Assistant Professor, Regional Institute of Ophthalmology, Government Medical College, Thiruvananthapuram, Kerala 695 035, India