EYE DISORDERS IN CD
Extraintestinal Complications: Eye Disorders
Approximately 10 percent of people with IBD experience eye problems. Although most of these are curable and do not represent any danger as far as loss of vision is concerned, inflammation of the eye should always be evaluated urgently by a physician.
Uveitis
Among the more common eye complications, uveitis is a painful inflammation of the uvea, which is the middle layer of the eye wall. People with uveitis may complain of blurred vision, pain, sensitivity to light, and redness of the eye. This symptoms may appear gradually or all of a sudden. The diagnosis of uveitis is made with a slit lamp. This is a special microscope that ophthalmologists use to look at the inside of the eye. This complication usually improves when the IBD is brought under control, but special eye drops containing steroids may help reduce inflammation. Uveitis may lead to glaucoma if left untreated.
Keratopathy is an abnormality of the cornea that develops in some people with Crohn's disease. Again, a slit lamp is used to make the diagnosis by identifying white deposits at the edge of the cornea. Because keratopathy does not cause any pain or loss of vision, no treatment is generally required.
Episcleritis is an inflammation of the episclera. This is the outer coating of the white of the eye. When the tiny blood vessels of the episclera become inflamed, they dilate and redden this area. In addition to redness, pain and tenderness may also be present. Steroid eyedrops and topical vasoconstrictors are commonly used to treat episcleritis, but the condition may resolve on its own as the patient's bowel disease gets better.
Dry eyes may occur as a result of vitamin A deficiency. This, in turn, may lead to eye irritation and infection; if the infection becomes severe, antibiotics may be necessary. Another consequence may be night blindness. Artificial tears provide relief of symptoms and vitamin A supplements, taken either by mouth or given as intramuscular injection, can reverse the deficiency.
Inflammation may also develop in other areas of the eye, such as the retina and the optic nerve, although this happens rarely. And cataracts may form after long-term steroid use as treatment for IBD. To be on the safe side, everyone with Crohn's or ulcerative colitis should make a point of having a regular examination by an ophthalmologist. Early detection of eye problems generally lead to successful treatment.
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