Rare Ocular Manifestations of Systemic Lupus Erythematosus--Two Case Reports

In systemic lupus erythematosus (SLE), ocular involvement is common (prevalence up to 30%) but extremely varied.The most common manifestation is keratoconjunctivitis sicca (in about 25%). Though posterior segment disease is not uncommon, choroidal involvement and optic neuropathy are rare. Visual loss from neuro-ophthalmic involvement is often due to lupus optic neuropathy. Less than five percent of patients only present with sole ocular involvement at diagnosis. We report two patients who presented with decreased visual acuity and rare posterior eye changes as presenting features of SLE in the absence of other clinical manifestations and later developed lupus nephritis.