Rheumatoid Arthritis and Dry Eye: Why Your Joints and Eyes Are Connected

Many people with rheumatoid arthritis (RA) focus on their hands, wrists, and knees. Fewer realize the disease can affect their eyes, and that dry, burning eyes may be part of the same immune process. In a recent Ophthalmology Times article, Meghan K. Berkenstock, MD, of the Wilmer Eye Institute’s Division of Ocular Immunology, explained why recognizing dry eye in RA matters.

Why RA affects women more

RA develops about three times more often in women than in men. No definitive reason has been found, though hormonal factors and other susceptibility factors have been suggested. Smoking and obesity are among the modifiable risk factors noted by the World Health Organization.

How RA causes dry eye

Dry eye is the most common eye problem in RA, along with secondary Sjögren’s syndrome. In RA, the immune system damages the lacrimal (tear) glands, so the eye does not make enough of the watery part of the tear film. Dr. Berkenstock noted that tear production problems occur in RA, as opposed to the evaporative type of dry eye. Symptoms include:

• Burning and redness
• Light sensitivity
• A gritty or foreign-body feeling
• Vision that fluctuates during the day

When it is more than dry eye

Scleritis, inflammation of the white outer wall of the eye, is the next most common eye problem in RA. It can affect the front or back of the eye and can threaten vision. Other possible problems include episcleritis, uveitis, keratitis, and retinal vasculitis. Eye disease can even appear before joint symptoms, so eye symptoms can sometimes help with an earlier diagnosis.

It works the other way too: not everyone with dry eye has RA, and some people with RA never develop eye involvement.

How it is treated

For RA-related dry eye, Dr. Berkenstock described using a tapering course of a topical steroid for about a month along with longer-term anti-inflammatory drops such as cyclosporine or lifitegrast to help the ocular surface and tear production. Scleritis or retinal vasculitis may need systemic medicines, often coordinated with a rheumatologist.

What I tell patients with RA

• Tell your eye doctor you have RA or another autoimmune condition.
• Do not ignore eye pain, deep redness, or vision changes; get seen promptly.
• Keep your rheumatologist informed about eye symptoms, since they may reflect overall disease activity.
• Dry indoor air and long screen sessions can make symptoms worse, so take breaks and blink fully.

Our role

Khanna Vision Institute diagnoses and treats dry eye for patients throughout Los Angeles at our Beverly Hills office. When we see signs of scleritis, uveitis, or other inflammatory eye disease, we coordinate with your rheumatologist or refer you to an ocular immunology specialist.

Wondering what eye care might cost? LA Lasik Cost covers practical questions about care in Los Angeles.

Source: Women’s Health: Identifying dry eye in rheumatoid arthritis can make all the difference (Ophthalmology Times, 10/26/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.