The eye has evolved in a way to minimize inflammation, but on the other hand it has to balance this with the ability to protect itself from infections. As humans evolved, the eye evolved in a way to minimize inflammation so the eye could protect itself, as it is a critical part of our survival.īut, autoimmune diseases like lupus and rheumatoid arthritis can be strong enough in terms of immune response that they can bypass the “immune protected” state. The eye is an “immune privileged” organ, meaning that it is protected from our immune system much more so than any of our other organ systems except for the brain, ovaries, and testes. Lining the eye is a thin tissue called the conjunctiva, which is often more familiar to patients than other parts of the eye due to its susceptibility to inflammation, a condition known as conjunctivitis. Both chambers contain fluid, and when there’s inflammation in the eye, a specialist can often see inflammatory cells in the fluid. The inside of the eye is divided into two chambers: the anterior chamber and the posterior chamber. Both the retina and the choroid are susceptible to inflammation. The retina – the back part of the eye – is where the light that comes through the pupil is projected and interpreted by the optic nerve. Some of the conditions that can affect the sclera can also affect the cornea.
The cornea – the outside part of the eye that protects the lens – is physically connected to the sclera. The iris – the colored part of the eye – causes the pupil to let in the appropriate amount of light. Schwartzman explains, is the small black hole in the middle of the eye, which is actually an opening which opens and closes depending on how much light hits it. Since lupus can affect the entire system, however, including each organ in the body, it is not surprising that it can, in some cases, affect all the different parts of the eye. Schwartzman pointed out that eye complications in those with lupus are not usually caused by lupus itself, but by medications commonly used to treat the other medical manifestations of lupus.
“Because when you look at the eye,” he explains, “you can actually see the optic nerve.”ĭr. He went on to explain that the closest a physician can come to examining the nervous system as part of a physical examination is to take a close look at the patient’s eye. “It can tolerate quite a bit of injury, surgery, stress, and disease, and still function normally.” “The eye is a very elegant organ, and it’s an organ that’s very complicated and a lot more resilient than you think it is,” he began.
He began by explaining that before he delved into the way lupus relates to the eyes, he intended to provide a brief overview of the anatomy of the eye itself. In this presentation to the SLE Workshop at HSS, Sergio Schwartzman, MD spoke about the various eye problems associated with lupus, including uveitis, conjunctival issues, discoid lupus, sjogren's syndrome, vasculitis of the retina, and scleritis, among other issues.
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