A one year Cross Sectional study of Dry Eye in Rheumatoid Arthritis patients at KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belgaum

Abstract

Background and objectives: ABSTRACT Dry eye is a very common disorder of tear film resulting from either decreased tear production or increased tear evaporation. It is not a common cause of vision loss, but it is still a serious issue for people who have it. The symptoms become progressively troublesome and exert an increasing burden on the patients as the disease progresses or increases in severity. If not detected early, it can lead to sight threatening complications. Rheumatoid arthritis is a well known risk factor for dry eye occurrence. This study was undertaken to assess dry eye prevalence in rheumatoid arthritis patients. Methods: The study was conducted at J.N.Medical college , Belgaum for a period of one year (January 2007 to January 2008). 70 patients diagnosed to have rheumatoid arthritis were enrolled in this study. They were given an OSDI questionnaire, examined for signs of dry eye and subjected to four tests (Schirmer test, Tear film break up time, rose bengal test, Impression cytology), based on which they were labelled as being positive or negative for dry eye. Results: Dry eye prevalence was found to be as high as 48.5% among rheumatoid arthritis patients. High OSDI scores were found to correlate well with diagnostic tests done for dry eye. The occurrence of dry eye was found to be more among females and people with refractive errors. Prevalence was found to increase with the increase in xi age and increase in duration of rheumatoid arthritis. A significant number of patients also had evidence of dry mouth. There was no correlation between rheumatoid factor and occurrence of dry eye. Conclusion: Rheumatoid arthritis is a definite risk factor for occurrence of dry eye. Testing in patients of rheumatoid arthritis is essential to detect dry eye early in these patients. OSDI questionnaire is a useful screening tool for dry eye. Impression cytology is an easy and useful test to assess surface changes in dry eye patients. While testing for dry eye, other criteria such as patient’s age, sex, refractive error, duration of rheumatoid arthritis should also be taken into consideration.