Rheumatoid arthritis affects joints and eyes: 54-year-old woman's cornea "devoured"

Eyes are like a barometer of rheumatoid arthritis and many other rheumatic and immune diseases. When rheumatoid arthritis is in the active and recurrent stages, the eyes are often accompanied by certain lesions, which may cause blindness in severe cases. Corneal ulcer is one of them. Ms. Qi (pseudonym), 54 years old this year, has suffered from rheumatoid arthritis for many years. In the past two years, her vision has deteriorated significantly. When she is sick, she often suffers from pain and cannot open her eyes. After diagnosis by the Aier Eye Hospital affiliated to Wuhan University, Ms. Qi was diagnosed with "rheumatoid-related marginal corneal ulcer".

Ms. Qi lives in Wuhan, Hubei, and has a history of rheumatoid arthritis for nearly ten years. Not only has she suffered from joint pain and swelling for a long time, but the small joints in her hands and feet have also gradually become deformed. To make matters worse, Ms. Qi was surprised that eye diseases took advantage of the situation. In the past two years, Ms. Qi found that her eyes repeatedly became red, swollen, and painful, accompanied by a foreign body sensation. Her vision did not decrease significantly during this period, and she did not receive standardized treatment. However, since the second half of this year, Ms. Qi's eye symptoms have become more severe than before, with unbearable pain and difficulty seeing things. In order to seek treatment, she recently came to the Aier Eye Hospital affiliated to Wuhan University for treatment.

After examination by Wu Shangcao, deputy chief physician of the hospital's ocular surface and corneal disease department, it was found that there were large areas of gray-white irregular ulcers near the corneal margins under both eyes of Ms. Qi's cornea, deep into the stroma layer, and nearly half of the cornea had been eroded, even affecting the pupil area. Director Wu Shangcao judged that Ms. Qi suffered from marginal corneal ulcers, which mainly occur at the edge of the cornea and are crescent-shaped. They cause the tissue at the edge of the cornea to melt and thin, thus posing a threat to vision and the eyeball. Considering that Ms. Qi had suffered from rheumatoid arthritis for many years, after the rheumatoid factor was determined, rheumatoid arthritis was finally determined to be the "culprit."

Rheumatoid arthritis and corneal ulcers seem to have nothing to do with each other, so why do they occur together? In this regard, Director Wu Shangcao explained: "Rheumatoid arthritis is an autoimmune disease. In addition to joint symptoms, it can affect multiple systems of the body at the same time. In short, the patient's body produces antibodies against its own antigens, which attack the corneal tissue, causing corneal inflammation and ulcers." Shortly after admission, Director Wu Shangcao performed amniotic membrane transplantation on Ms. Qi to repair the defect, and gave her symptomatic treatment such as anti-inflammatory, anti-infection, and repair-promoting after the operation. When she was discharged from the hospital, Ms. Qi's corneal epithelium in both eyes was completely repaired, and her vision was significantly improved.

"Since eye symptoms are easily ignored by patients, most patients with rheumatoid-related corneal ulcers have been suffering from the disease for several years when they seek medical treatment. The condition is complicated and difficult to treat," said Director Wu Shangcao. For corneal ulcers, early diagnosis and standardized treatment are the top priorities. He reminded that patients with rheumatoid arthritis should control their condition with medication and have their rheumatoid control checked regularly. If red and painful eyes, foreign body sensation, decreased vision, etc. occur, they should be alert and go to the hospital's ophthalmology department for treatment in time.