Ocular pathology, tear production, and tear lysozyme in rheumatoid arthritis

Ninety-seven rheumatoid arthritis (RA) patients receiving investigational nonsteroidal antiinflammatory drugs were found to have a 31.9% prevalence and 24.5%/year incidence of ocular pathology. None of these ocular lesions were definitely related to their RA or drug therapy. Twenty-one of these patients were studied further for evidence of keratoconjunctivitis sicca. None of these patients had abnormal rose bengal staining, but over half had decreased tear production on both stimulated and unstimulated Schirmer's testing and many patients had high tear lysozyme levels. Increased tear lysozyme levels and decreased Schirmer's tests correlated with a modified rheumatoid activity index.