How Crohn's Disease Affects Your Eyes
Crohn's disease is an inflammatory bowel disease that causes inflammation and irritation in the digestive tract. While its main symptoms involve digestive problems like diarrhea, abdominal pain, and malnutrition, Crohn's can also impact other parts of the body - including the eyes.
Ocular Manifestations of Crohn's
Nearly 4-12% of Crohn's disease patients develop some form of inflammatory eye condition. These are collectively referred to as "ocular manifestations" or extraintestinal symptoms. The most common include:
- Uveitis - inflammation of the middle eye layer (iris, ciliary body)
- Episcleritis - inflammation of the outermost eye layer
- Conjunctivitis - inflammation of the thin tissue layer covering the white part of eyes and inner eyelids
- Keratopathy - corneal clouding, swelling or erosions
- Retinal vasculitis - blood vessel inflammation in the retina
- Optic neuritis - swelling around optic nerves, causing vision loss
What Causes Eye Inflammation?
The exact mechanisms behind inflammatory bowel disease (IBD) related eye conditions remain unclear. Researchers believe it stems from an abnormal autoimmune response. Due to a genetic predisposition, the body mistakes healthy cells for "invaders" and attacks itself when triggered by various factors like infections, medication, stress or nutritional deficiencies. This leads to systemic inflammation throughout the body, including fragile ocular tissues.
Signs Your Crohn's Disease is Worsening
Persistent or sudden onset of eye problems may signal that overall Crohn's disease activity is flaring up. Here are key symptoms to watch out for:
Vision Changes
Blurred vision, floaters, distorted sight, blind spots, light sensitivity, eye discomfort/pain, excessive watery eyes, flashing lights and difficulty seeing at night could all indicate inflammatory eye issues related to Crohn's getting worse.
Eye Redness
Increased blood vessel inflammation makes eyes appear red, especially on the whites/sclera. You may notice irregular bright red patches or diffuse pinkish hue.
Light Sensitivity
Also termed photophobia, difficulty tolerating light is common with uveitis, keratopathies and similar IBD eye complications. Bright indoor lights, sunlight, computer screens or reading can worsen discomfort.
Vision Loss Symptoms
Rapid vision deterioration, complete loss of vision in an eye or seeing halos/hazes around lights demands urgent medical care to prevent permanent eye damage associated with severe vasculitis, macular edema or optic neuritis.
Getting an Eye Exam for Crohn's Patients
Since inflammatory bowel diseases are chronic and progressive, regular eye check-ups are crucial to screen for emerging ocular manifestations even without notable vision symptoms. Here's what to expect:
Comprehensive Eye Health History
Ophthalmologists will inquire about your Crohn's diagnosis date, severity, medication/treatment history, digestion issues and eye-related problems to date. Bring a list of all current prescriptions and supplements too.
Visual Acuity Assessment
Standard letter eye charts measure how clearly you see at various distances. Differing vision between eyes indicates irregular astigmatism or focusing issues.
Eye Alignment and Movement Testing
Covering one eye then the other checks for muscle imbalance. Eye tracking exercises also spot restricted mobility from inflammation.
Pressure and Anatomy Measurements
Tonometry detects abnormal intraocular pressure levels signaling conditions like glaucoma. Imaging scans photograph internal eye structures, blood vessels and optic nerves for comparative analysis.
Dilated Fundus Exam
After dilating/widening pupils with medicated eye drops, the ophthalmologist looks inside your eyes (the fundus) for retinal inflammation, macular abnormalities or optic nerve damage using specialized viewing lenses and bright lights.
Treatment Options for Crohn’s Related Eye Disorders
Specialty ophthalmologists collaborate with your gastroenterologist to determine appropriate management plans for IBD associated eye problems like:
Corticosteroid Eye Drops/Ointments
Potent anti-inflammatory glucocorticoid formulations reduce acute uveitis or scleritis flares when applied directly to eyes as prescription eye drops or gels.
Immunosuppressant Medications
Oral tablets or injectables taken daily or weekly calm an overactive immune system prone to attacking its own tissues over time. Options include methotrexate, infliximab, adalimumab, vedolizumab and more.
Surgery
Severely damaged internal eye structures may necessitate surgical interventions like corneal transplants, lens replacements, torn retina repair and drainage implants to reduce inflammation and high eye pressure.
The key is getting regular eye exams and communicating new vision changes to catch Crohn’s disease related problems early to prevent permanent damage. Don’t take your eyesight for granted!FAQs
What eye problems are associated with Crohn's disease?
Common inflammatory eye conditions linked to Crohn's disease include uveitis, episcleritis, conjunctivitis, keratopathy, retinal vasculitis, and optic neuritis. Overall, 4-12% of Crohn's patients develop some form of "ocular manifestation".
What eye symptoms signal my Crohn's is getting worse?
Worsening Crohn’s disease can trigger eye inflammation. Key signs include vision changes, light sensitivity, excessive eye redness, pain/discomfort, blurred sight, floaters and complete vision loss or blurriness in one eye.
Should I see an eye doctor if I have Crohn’s without vision issues?
Yes, regular eye exams are important for Crohn’s patients to screen for silent ocular manifestations before vision deteriorates. Sudden onset eye inflammation related to Crohn’s tends to cause permanent damage without prompt treatment.
How are Crohn’s related eye problems treated?
Treatments for inflammatory eye diseases in Crohn's patients include prescription steroid eye drops, immunosuppressive medications to control overall inflammation, and rarely - ocular surgeries for severe cases unresponsive to other methods.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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