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Ocular Manifestations in Rheumatoid Arthritis Patients - A Hospital Based Cross Sectional Study

BACKGROUND The prevalence of rheumatoid arthritis (RA) in India is 0.28% to 0.7%, 15-45% of patients with RA develop ocular manifestations. Ocular disabilities can be reduced with timely interference by an ophthalmologist. Keratoconjunctivitis sicca (Sjogren’s syndrome) is the most common ocular association of RA. This study was done to find out various ocular manifestations in rheumatoid arthritis patients. METHODS A cross sectional study was conducted among the patients attending the rheumatology clinic at Government Medical College, Trivandrum. Patients in the age group of 18-60 years were screened and further evaluated at regional institute of ophthalmology, Trivandrum. Screening for RA was done using the American Rheumatism Association criteria. A complete ophthalmic examination was done for those who satisfied the criteria. The various ocular manifestations in RA are described and presented as proportions. RESULTS Ocular manifestation was found in 38% of total patients attending the rheumatology clinic. There were 54 females (80.5%) and 13 males (19.4%). Age group mainly affected were in 46-50 yr (17.9%). The duration of rheumatoid arthritis ranged from few months to 25 years. Keratoconjunctivitis sicca was the commonest manifestation found, detected in 22(84%) patients, episcleritis was noted in two patients (7.6%), scleritis in 1 patient (3.8%) and marginal furrowing in 1 patient (3.8%). CONCLUSIONS In this clinic-based study there was a high proportion (38%) of ocular involvement in RA and hence it is essential to include ophthalmic evaluation as a routine in RA patients. The most common manifestation was keratoconjunctivitis sicca followed by episcleritis, diffuse anterior scleritis and marginal corneal furrowing. KEY WORDS Rheumatoid Arthritis, Keratoconjunctivitis Sicca, Ocular Manifestations, Scleritis, Episcleritis