Q: My mother, who is 74 now, has been struggling with her arthritis for years, but lately she is also telling me her eyes are scratchy and dry. She’s having more trouble reading her Bible and medication labels. Is this related to her arthritis?
A: Your mom likely has a very common symptom of rheumatoid arthritis, but one that is often overlooked. It is not uncommon for many systemic diseases to have eye effects also, but those are frequently not adequately addressed.
Arthritis is fundamentally a disease of inflammation, as opposed to infection. While that sounds better, inflammation is difficult (if not impossible) to fully control. Inflammation of this type is really your body’s immune system attacking your body. This internal battle can manifest itself in many ways, including our eyes. Our eyes are normally bathed in a complex mixture of fluids we call our “tear film” to keep the surface moist and lubricated. Unfortunately, some of the tear fluid producing glands around the eyes are impaired by bodily inflammation.
Fortunately, we now have in-office tests that use a tiny sample of your tears to identify the cause of poor tear fluid. These guide us in prescribing eye medications to reduce inflammation, or to recommend other treatments. So far, we have only two medications specifically approved for inflammatory dry eye disease, and both are eyedrops. There are no oral meds yet to solve this common problem. Many patients, like your mom, also have significant relief with “lacrimal plugs” to hold her tear film on the eye surface better.
I should add that there is some evidence that oral omega-3 fatty acids, as in certain fish oils, may provide better tear fluids also. Many fish oils do not, so ask your eye doctor for a specific recommendation of omega-3 for your eyes. And wearing a gel bead sleep mask can also help to keep eyelids fully closed overnight, and allow better healing.
Lastly, I would add that these eye symptoms are so important, yet overlooked for a couple reasons. Certainly, dry uncomfortable eyes are not life threatening and are often not taken seriously by many family members or even your doctor. At this stage of life, comfortable clear vision is extra important — both for mobility safety and for reading enjoyment. So talk to your eye doctor about these new tear film tests and the new treatments that are proving very successful. Restoring comfortable and clear vision in this season of life is so important and valuable.
DR. THOMAS STOUT, OD, FAAO is an eye physician in private practice at Morgantown Eye Associates. Info: MorgantownEye.com.