Lupus is a chronic autoimmune disease. The inflammation that it causes can damage many of your tissues, but the drugs used to treat it can also lead to complications. If you have lupus, you may develop cataracts, a sight-threatening clouding of the cornea, the lens of the eye. Here are four things lupus sufferers need to know about cataracts.
How does lupus cause cataracts?
On its own, lupus doesn't cause cataracts. The problem is the drugs that are used to control your lupus. To control the inflammation that lupus causes, sufferers are often prescribed corticosteroids. Corticosteroids reduce inflammation throughout the body and help to stave off inflammation-related tissue damage, but corticosteroids have serious side effects, including cataract formation.
Corticosteroid use is a major risk factor for developing cataracts and is responsible for 4.7% of cataract extractions. It's still not known how corticosteroids damage the lens of the eye, but many theories have been proposed. One theory is that corticosteroids affect the growth factors within your lens and allow cells to develop abnormally, leading to cataracts. More research needs to be done to confirm this, but whatever the reason, it's well-established that corticosteroids can cause cataracts.
How can you protect your eyes?
If you're taking corticosteroids to control your lupus, the best way to protect your eyes is to see your optometrist regularly for eye exams. Make sure to tell your optometrist that you have lupus and are taking corticosteroids to control it. Generally, eye exams should occur at least once every two years, but due to your condition, your optometrist may want to see you on a more frequent schedule.
Your optometrist will carefully examine your eyes for signs of cataracts. A slit lamp will be used to view your eyes; under magnification, your optometrist will check your corneas, one small section at a time. These regular examinations make it possible for cataracts to be found early, before they've caused any symptoms.
Steroid-sparing treatment regimens are also available, so your optometrist may recommend speaking to your rheumatologist about switching to a lower-risk medication. For example, antimalarial drugs like aminoquinolone or chloroquine can be used instead of corticosteroids.
What are the signs of cataracts?
In between your regularly scheduled exams, you need to be monitoring your eyes for changes that could indicate cataract development. Cataracts can lead to many changes in your vision. A major warning sign is that your vision looks cloudy or blurred. You may also notice that you have trouble seeing in dark rooms or at night. Even if the changes in your vision seem minor, make sure to take them seriously and bring them to your optometrist's attention.
How are they treated?
The treatment for cataracts depends on how severe they are. If your cataracts are small and don't affect your vision too much, your optometrist may recommend leaving them alone.
If the cataracts are large and are severely impacting your vision, they can be surgically removed. This can be done through a process called phacoemulsification. An ultrasound device will be used to break your cataract into smaller pieces, and then these small pieces will be removed. Once the cataract has been removed, an artificial lens will be implanted. After the surgery, you'll need to wear a protective shield over your eye to protect it while it heals.
Newer cataract removal techniques are still being developed. For example, cataract removal eye drops have shown success in both rabbits and dogs. In the future, it's possible that you'll only need to use eye drops to get rid of your cataracts, and won't need surgery.
If you have lupus, make sure to see your optometrist regularly to get screened for cataracts. To learn more, click here for additional reading.