About 10 percent of Americans with some form of inflammatory bowel disease (IBD) may also end up developing problems with impacted vision. This is important to monitor, as the anti-inflammatory medications used to treat ulcerative colitis (UC), such as corticosteroids, may cause the patient to develop glaucoma and cataracts if used long-term. Although Black Americans have a lower rate of diagnosis for IBD-related illnesses, they are less likely to have access to medical care.
Lack of access to adequate care for UC that remains untreated may also lead to more serious vision problems. Sometimes a patient does not know they have UC unless their eye doctor notices something irregular during an eye exam, such as redness of the eye, or small white spots on the cornea.
Episcleritis
Episcleritis is a redness and swelling of the connective tissue that covers the white part of the eye known as the sclera. There may also be inflammation of the episclera, the connective tissue between the sclera and the conjunctiva, the mucous membrane covering the front of the eye.
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Episcleritis often resolves on its own in a few weeks, but in the meantime, your doctor may prescribe corticosteroid eye drops, artificial tear eye drops, or nonsteroidal anti-inflammatory drugs (NSAIDs) like Motrin or Advil.
Scleritis
Scleritis, or inflammation of the sclera connective tissue, has the potential to severely impact your vision as it is chronic and related to an autoimmune disorder. It’s marked by painful inflammation and redness in the white part of the eye.
By comparison, it is less common and more painful than episcleritis. In more severe cases, the redness may have a purple-ish hue, and the eye may become teary and very sensitive to light.
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If left untreated, scleritis can lead to permanent vision loss. Treatment for scleritis includes steroid eye drops, oral antibiotics and NSAIDs such as prednisone.
Dry eye syndrome
Burning, dryness, and itching of the eyes are all symptoms of dry eye, which is when your eyes do not produce enough tears. It’s also a condition that can result from an IBD-related vitamin A deficiency. The inflammation in the small and/or large intestine caused by IBD can inhibit the absorption of vitamin A from food.
The most common treatments for dry eye are artificial tears and supplements for vitamins A, E, B6, and riboflavin.
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Keratopathy
Keratopathy is a rare disease of the cornea that can occur in people with IBD or other systemic diseases. Symptoms include eye pain and redness, excess tears or discharge, the sensation that something is in your eye, and sensitivity to light. Small, white calcium deposits on the cornea may also appear, which would be evident during an eye exam.
The condition does not generally cause vision loss, but it can cause decreased vision. Treatment for mild to moderate keratopathy includes antibiotic drops, special contact lenses, and steroids, although it may resolve on its own.
Uveitis
Like many of the aforementioned conditions, patients suffering from uveitis experience eye pain, redness, light sensitivity, and blurred vision. Uveitis is an inflammation of the middle layer of the eye wall, which can lead to glaucoma or even vision loss if left untreated.
For a course of treatment, an eye doctor may prescribe eye drops, steroids in pill form, and injections or eye implants for more severe cases.
It is strongly advised to seek medical care if any of these symptoms appear, and to at least seek community care that can lead to medical care if access to an eye doctor is not immediately within reach.
When to see a doctor
If you experience any of these symptoms, it is crucial to see your doctor promptly. Early detection and treatment of UC-related eye issues can help prevent more serious complications and protect your eyesight. Regular check-ups with an ophthalmologist are also recommended for individuals with UC to monitor for any potential eye involvement.
