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Ocular Disease

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Ocular manifestations in SLE are quite common and can sometimes be vision threatening. They may also often be the first manifestations of the disease.(2,3) SLE can affect any part of the eye and visual pathway. Also, some ocular manifestations can result from the use of some drugs in the treatment of SLE like hydroxychloroquine and steroids. Foster et al found Dry eye syndrome (keratoconjunctivitis sicca) is the most common ocular feature of SLE (around a third of patients) and is often associated with secondary Sjogren’s syndrome [ 5]. We had a very high incidence of 48% of dry eyes making it the most common manifestation in our study. Orbital masses, periorbital oedema, orbital…show more content…
72% of such cases result in proliferative retinopathy along with vitreous haemorrhage, or traction retinal detachment. Our study had 8% APLA positive patients. Optic nerve disease occurs in around 1% of patients with SLE (15,]as found by Georgi et al.Our study had a 2 % incidence of optic neuritis and 6 %cranial nerve palsies. Comparison with other studies Table1 Ostanek etal,Poland,2007(16) Yap etal,Singapore,1998(17) Our study KCS 57.3% 64% 48% Cataract 10% 8% Retinopathy 20% 13% 24% Occlusive vasculopathy 4.3% 6% Decreased visual acuity 22.6% 10% 25% There is a paucity of published studies on SLE from our country and most of the comparable studies are from Poland where there is a relatively high incidence of SLE and from Singapore and japan. Our study had a comparable incidence of dry eye , decreased visual acuity and retinopathy compared to the polish study by ostanek et al .However the study in Singapore by Yap etal had a much higher incidence of dry eyes and lower retinopathy and decreased visual acuity. (table 1)This could be explained on the basis that being a multispeciality hospital our department tends to see patients with a higher disease activity index and patients on longterm immunosuppression. The strong association between antiphospholipid antibody positivity and vasoocclusive vasculopathy has been seen in several other studies
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