Frequency and Spectrum of Ocular Manifestations Among Patients With Systemic Autoimmune Rheumatic Diseases: A...

Systemic autoimmune rheumatic diseases may cause a wide range of ocular manifestations, ranging from dry eye disease to potentially vision-threatening inflammatory and vascular complications. Data regarding the frequency and spectrum of ocular involvement among patients with systemic autoimmune rheumatic diseases in Pakistan remain limited. This study aimed to determine the frequency and spectrum of documented ocular manifestations among patients with systemic autoimmune rheumatic diseases.

A retrospective, hospital-based cross-sectional study was conducted at Gulab Devi Teaching Hospital, Lahore, Pakistan, using medical records from May 2026 to August 2026. Adult patients aged ≥18 years with an established systemic autoimmune rheumatic disease who attended rheumatology or ophthalmology outpatient departments or were admitted to any inpatient department were eligible. Patients with insufficient records to determine the underlying rheumatic diagnosis or ocular status were excluded. Each patient was counted only once. Data included demographics, rheumatic diagnosis, disease duration where documented, and presence and type of ocular manifestation. Ocular involvement was defined as at least one documented ocular manifestation. Data were analyzed using SPSS Statistics (IBM Corp., Armonk, NY, USA). Categorical variables were summarized as frequencies and percentages.

A total of 210 unique eligible patients were included. The mean age was 37.6 ± 12.8 years, and 164 (78.1%) were female. Rheumatoid arthritis was the most common rheumatic disease (82, 39.0%), followed by systemic lupus erythematosus (SLE) (57, 27.1%) and spondyloarthritis (26, 12.4%). Overall, 94 (44.8%) patients had at least one documented ocular manifestation. Dry eye/keratoconjunctivitis sicca was the most frequently documented manifestation (39, 18.6%), followed by uveitis (24, 11.4%), scleritis (13, 6.2%), episcleritis (7, 3.3%), cataract (6, 2.9%), peripheral ulcerative keratitis (5, 2.4%), glaucoma (5, 2.4%), and retinal vasculitis (4, 1.9%).  Conclusion: Ocular manifestations were frequently documented among patients with systemic autoimmune rheumatic diseases, with a broad spectrum of ocular involvement observed across different rheumatological diagnoses. The findings highlight the importance of recognizing ocular disease in these patients and support collaboration between rheumatology and ophthalmology services. Further prospective multicenter studies using standardized ophthalmological assessment are warranted.