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
If Herpes simplex virus infects the eye it causes pain, sensitivity to light and discharge and can cause scarring.
ANA: test for these autoantibodies (very general); DsDNA (+): Making antibodies to and attacking own DNA; Anti-Sm (+): these antibodies generally interfere with the cells metabolism and are responsible for the symptoms specifically seen with SLE. Here, they are specifically targeted at smooth muscle. CRP elevated: also indicates presence of inflammation, but is more specific towards disease activity; ESR elevated: indirectly indicates the activity of the disease and presence of inflammation; C3 and C4 (decreased): C3 and C4 usually attack the membranes of viruses and bacteria, but in the case of lupus, they attack the own body’s cells. When C3 and C4 suggest the disease is active
Glaucoma can occur without much warning, whether its acute from a accident in which a trauma is issued on the eye, or if it is due to age and heredity. Glaucoma doesn 't discriminate, it is seen in all races and genders. It happens so slowly with age and heredity that you don 't even notice the loss of vision until it is too late, and with acute glaucoma it can be painful with pain that radiates over the face, a headache, nausea, vomiting and seeing colored halos around lights and even blurred vision can be a few symptoms (Ignatavicius & Workman, 2013). Once you start seeing halos, and lose peripheral vision, it may be an indicator that irreversible damage to the optic nerve has happened. In this paper we will discuss the pathophysiology of glaucoma, the types of glaucoma as well as the causes for them. the issues that glaucoma can cause someone, and the treatments and interventions. We will also have a education handout to help better understand how to administer the medication, and the effects it has on the eye.
Currently there are no treatments for cure of SLE. The only treatments available are treatments to suppress the progression on the disease, treatments to address complications cause by SLE, and treatments to relieve patients from the discomfort. There is no known etiology for SLE; therefore, there are no prevention methods for SLE. The recent improvement of the understanding of autoimmune diseases; in general, has helped improve prognosis. Faster and more precise diagnosis, leading to earlier treatment in suppressing the progression of the disease is allowing more patients to live a normal life span. Also, the 2011 FDA approval of the biologic drug called Belimumab has contributed to the improvement of prognosis. More research directed towards the understanding autoimmune disorder is needed. Unfortunately, the current knowledge is not enough to provide adequate and timely diagnosis. Due to the tight commonality among autoimmune diseases, a thorough understanding of the immune system is required to develop more effective treatments and a cure for systemic lupus
Matured cells, known as thymus dependent cells (T-cells) and bone marrow derived cells (B-cells) play an enormous role in protecting the body from harmful agents and antigens (Blau). Normally, lymphocytes are supposed to ignore the body’s own antigens; however, other cells that communicate with lymphocytes single out the foreign cells that do not belong so that the lymphocytes can destroy them. The T-cells interact with antigens, and is commonly known to be the body’s line of defense against microorganisms. It also can sometimes be referred to as the helper or the suppressor (Blau). In a person with SLE, the number of T-cell production is reduced, causing damage to CD8+ T-cells and activating CD4+ helper T-cells in order to elevate the amount of B-cells being produced (La
Systemic Lupus Erythematosus (SLE) is a genetic disorder. SLE is a type III hypersensitivity or an autoimmune hypersensitivity (VanMeter, K. C., PhD, & Hubert, R. J., BS, 2014). Meaning that the body is attacking itself. In SLE a large number of autoantibodies circulate through the body (VanMeter, K. C., PhD, & Hubert, R. J., BS, 2014). These autoantibodies are deposited into the connective tissue all over the body (VanMeter, K. C., PhD, & Hubert, R. J., BS, 2014). These autoantibodies activate the complement system and cause inflammation and necrosis of the tissue that the autoantibodies are near (VanMeter, K. C., PhD, & Hubert, R. J., BS, 2014). This usually takes place in many systems in the body. In order to be diagnosed at least four body systems have to be affected.
The diagnosis of SLE is difficult. Autoimmune diseases are a group of related conditions that present similar symptoms. One autoimmune disease is not a unique disease with its own unique symptoms. Instead autoimmune diseases are a group of related conditions (see fig 2 and table 2). Currently there are no definite number of how many autoimmune diseases exist; however, there is a range of autoimmune diseases that varies from 80 to as
Lupus can either be mild, or it can be lethal. Unfortunately, SLE is not contained to one part of the body, but rather can affect any part of the body (Lockshin, 2007). In order to help with the diagnosis of lupus, the American College of Rheumatology developed the “Eleven Criteria of Lupus” which contains the typical symptoms of SLE and is used by doctors to diagnose patients. Diagnosis, of course, is not limited to the eleven criteria. The first symptom is called the malar-rash, also known as the butterfly rash, is found on the face spread across the patient’s cheekbones. Second, are discoid patches, third is photosensitivity- a reaction to sunlight that results in skin rashes. Fourth is mouth or nose ulcers, where the mouth ulcers of someone who has lupus, is pain-free and appear at the roof of the mouth instead of on the sides. The fifth symptom is nonerosive
All patients fulfilled at least four of the revised classification criteria for SLE of American College of Rheumatology (ACR) as described in table ()
Systemic Lupus Erythematosus (SLE) has its own specific sign and symptoms, which each person with this disease may has slightly different symptoms which can range from mild to severe and may come and go over time. The common symptoms of SLE are painful or swollen joints and muscle pain, unexplained fever, red rashes (butterfly rashes) which usually on the face, chest pain upon deep breathing, unusual loss of hair, pale or purple fingers or toes from cold or stress which also know Raynaud’s phenomenon, sensitivity to the sun causing the skin to become seriously irritated, swelling (edema) in legs or around eyes, mouth ulcers, swollen glands and extreme fatigue. However, SLE’s symptoms mostly include painful joint, unexplained fever and extreme
Systemic lupus erythematosus (SLE) is a chronic inflammatory and autoimmune disease of multifactorial etiology that can affect many organs and systems (Sato, 2002).
Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disease that occurs when a person’s immune system attacks your own tissues and organs. SLE is characterized by the presence of autoantibodies directed against nuclear antigens. By definition, SLE is a multi-system disease, and patients can be infected in vastly different ways. SLE is the form of the disease that most people are referring to when they say “lupus.” The word “systemic” means the disease can affect not one, but many parts of the body (Johnson, 1999). SLE can affect every organ in the human body. The most common manifestations are rash, arthritis and fatigue. According to the Mayo Clinic, some complications of SLE are kidney failure, neurological problems, anemia,vasculitis,
Glaucoma is a family of diseases that if left untreated can lead to permanent blindness. “Primary open-angle glaucoma is the leading cause of blindness in the United States and worldwide (Goldberg).” African Americans are four to five
also is worsened by exposure to cold. Eyes may be sensitives to light so the person with this pain
Systemic Lupus Erythematosus is a chronic autoimmune disease which causes inflammation of your joints, tissues, and organs. The inflammation presents itself as heat, pain, swelling and redness. SLE is a variable disease that doesn’t take any one particular course; therefore its unpredictability makes it even more devastating. No two people will experience the same disease symptoms or severity level. As S.L.E progresses there will be periods of very subtle to no symptoms at all called remission or an exacerbation of symptoms called flares.