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Keratoconjunctivitis sicca in rheumatoid arthritis.

G M Mody1, J C Hill, O L Meyers

  • 1Department of Medicine, Groote Schuur and Princess Alice Orthopaedic Hospitals, South Africa.

Clinical Rheumatology
|June 1, 1988
PubMed
Summary

Rheumatoid arthritis patients frequently experience dry eye disease, or keratoconjunctivitis sicca (KCS). Rose bengal staining is crucial for diagnosing KCS in RA patients, as other tests can be misleading.

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Area of Science:

  • Ophthalmology
  • Rheumatology
  • Immunology

Background:

  • Rheumatoid arthritis (RA) is a systemic autoimmune disease.
  • Keratoconjunctivitis sicca (KCS), or dry eye disease, is a common comorbidity in RA patients.
  • Accurate diagnosis of KCS in RA is essential for appropriate management.

Purpose of the Study:

  • To determine the prevalence of KCS in a randomly selected RA patient cohort.
  • To evaluate the diagnostic utility of the Schirmer's test and rose bengal staining for KCS in RA.

Main Methods:

  • A cohort of 104 rheumatoid arthritis patients was randomly selected.
  • Patients were screened for symptoms of KCS.
  • Rose bengal staining and slit lamp examination were performed to diagnose KCS.
  • Schirmer's test, tear film, and tear break-up time were assessed.

Main Results:

  • The overall prevalence of KCS in the RA cohort was 21.2%.
  • Rose bengal staining confirmed KCS in 22 patients.
  • Schirmer's test showed abnormalities in most KCS patients, but only 8 had severe reduction (<5 mm).
  • Reduced marginal tear film and tear break-up time were observed in a majority of KCS patients.

Conclusions:

  • Keratoconjunctivitis sicca is highly prevalent in patients with rheumatoid arthritis.
  • The Schirmer's test alone is insufficient for diagnosing KCS in RA.
  • Slit lamp examination with rose bengal staining is essential for accurate KCS diagnosis in RA patients.

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