Ocular Manifestations of Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by production of numerous antibodies that may affect multiple organ systems. Wide variety of systemic features of SLE are attributed to antibodies against the components of cell nuclei. Many of the clinical features, like nephritis and arthritis are due to deposition of immune complexes resulting in tissue damage. Other features of the disease such as hemolytic anemia, thrombocytopenia is due to direct effect of autoantibodies. The ocular manifestations of SLE include lid dermatitis, keratitis, scleritis, secondary Sjogrens syndrome, retinal and choroidal vascular lesions and neuroophthalmic lesions. Keratoconjunctivitis sicca is the most common ocular manifestation, but visual morbidity is usually due to retinal and neuro-ophthalmic manifestations of the disease. Ocular involvement may precede systemic onset of the disease. Early recognition of ocular disease by an ophthalmologist may prevent not only the blinding complications of SLE but also alert the clinician to the likely presence of disease activity elsewhere and timely institution of systemic therapy.