Lacrimal defects in adult and senile rheumatoid arthritis

Rheumatoid arthritis presents with different clinical manifestations according to the age of onset. The authors have studied the involvement of the lacrimal function in two different cohorts of patients, 70 adult-onset (onset of the disease between 15 and 60 years of age) and 30 old-onset (60-79 years), as compared to two groups of normal controls of the same age. Schirmer I, Break-Up Time (BUT), and Bengal rose were tested. Senile rheumatoid arthritis (SRA) not only did not show more severe lacrimal changes when compared to adult rheumatoid arthritis (ARA) of the same duration, but failed to show statistical differences in tear secretion when compared to a healthy population of the same age. ARA patients showed a significant tear deficiency when compared to a healthy population of the same age. Within this cohort of patients, 'long-lasting' ARA showed more severe changes when compared to 'short-lasting' ARA. These results would suggest that the involvement of the lacrimal system is more important when rheumatoid arthritis develops in adult rather than in old age, being a function of the duration rather than of the severity of the disease.