{"id":18185,"date":"2026-08-19T12:10:19","date_gmt":"2026-08-19T12:10:19","guid":{"rendered":"https:\/\/www.eyecliniclondon.com\/blog\/?p=18185"},"modified":"2026-08-19T12:19:34","modified_gmt":"2026-08-19T12:19:34","slug":"lupus-eye-problems","status":"publish","type":"post","link":"https:\/\/www.eyecliniclondon.com\/blog\/lupus-eye-problems\/","title":{"rendered":"Can Lupus Cause Eye Problems?"},"content":{"rendered":"

If you have lupus, you may already know that it can affect more than your joints or skin. Because lupus can cause inflammation throughout your body, it may also affect your eyes and vision. You may experience relatively mild problems such as dryness, grittiness or irritation, while less commonly, lupus can cause inflammation in deeper parts of the eye.<\/p>\n

Hydroxychloroquine is an important treatment for many people with lupus, but prolonged treatment can cause retinal toxicity in a small proportion of patients. The risk increases with factors such as treatment duration, higher daily doses and impaired kidney function, which is why scheduled retinal monitoring is important.<\/p>\n

Why Can Lupus Affect Your Eyes?<\/h2>\n

Lupus is an autoimmune condition that can cause inflammation throughout your body rather than affecting just one area. Structures within and around your eyes include the tear glands, sclera, retina and optic nerve, which can sometimes be affected by inflammation or changes in small blood vessels.<\/p>\n

However, having lupus does not mean you will develop eye disease. Your risk depends on factors such as how active your lupus is, your general health and the medicines you use. Serious inflammatory eye complications directly related to lupus are relatively uncommon, although retinal involvement can sometimes be associated with greater systemic disease activity.<\/p>\n

What Types of Eye Problems Can Lupus Cause?<\/h2>\n

If you have lupus, you may experience dry, gritty or irritated eyes, sometimes with watering or fluctuating blurred vision. Lupus can also cause inflammation of the tissues around the white part of your eye, leading to conditions such as episcleritis or the more painful scleritis.<\/p>\n

Less commonly, lupus can affect the retina and its blood vessels, potentially causing changes that may threaten your sight. Rarely, inflammation can involve the choroid or optic nerve. Because different eye problems can cause similar symptoms, persistent or unusual changes in your vision should be assessed by an eye specialist.<\/p>\n

Evidence Note<\/strong><\/p>\n

Eye involvement is a recognised feature of systemic lupus erythematosus, although reported prevalence varies according to the population studied and how ocular disease is defined. A systematic review and meta-analysis of 65 studies estimated ocular involvement in approximately 31% of people with SLE, with dry eye among the most frequently reported manifestations.<\/p>\n

More serious complications involving the retina, choroid or optic nerve are much less common but can be clinically important because they may threaten vision and, in some cases, occur alongside more active systemic disease. Population-level figures cannot predict your individual risk of developing a particular eye complication.<\/p>\n

Why Can Lupus Make Your Eyes Feel Dry?<\/h2>\n

If you have lupus, inflammation and changes affecting tear production or the ocular surface can contribute to dry eye. Your eyes may feel sandy, gritty, tired or irritated, and you may experience burning, stinging, light sensitivity or fluctuating blurred vision.<\/p>\n

Dry eyes can sometimes water excessively because irritation triggers reflex tears, which do not always provide lasting lubrication. If your dryness continues despite using lubricating drops, you should have your eyes assessed to identify the cause and find suitable treatment.<\/p>\n

Is Dry Eye Sometimes Related to Sj\u00f6gren\u2019s Syndrome?<\/h2>\n

If you have lupus, persistent dry eyes may sometimes be linked with Sj\u00f6gren\u2019s disease, another autoimmune condition that affects the glands responsible for producing moisture. You may also notice a noticeably dry mouth when both conditions are present.<\/p>\n

However, having dry eyes does not automatically mean you have Sj\u00f6gren\u2019s disease. Dryness can have many other causes, including ageing, medication, contact lenses and prolonged screen use. If your symptoms are persistent or severe, your eye specialist and rheumatology team can assess whether further investigation is needed.<\/p>\n

Can Lupus Cause a Painful or Red Eye?<\/h2>\n

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If you have lupus, you can develop a red or painful eye from inflammatory conditions such as episcleritis or scleritis. Episcleritis usually causes a localised area of redness with mild soreness, while scleritis affects deeper tissues and can cause severe, deep eye pain.<\/p>\n

A very painful red eye should not be assumed to be conjunctivitis or ordinary irritation. Seek urgent ophthalmic assessment if redness is accompanied by severe or deep eye pain, marked light sensitivity or changes in your vision.<\/p>\n

Myth vs Fact<\/h2>\n\n\n\n\n\n\n\n\n\n
Myth<\/strong><\/td>\nFact<\/strong><\/td>\n<\/tr>\n<\/thead>\n
Lupus only affects your joints and skin.<\/td>\nLupus is a systemic autoimmune condition and can occasionally affect several parts of the eye, including the ocular surface, sclera, retina, choroid and optic nerve.<\/td>\n<\/tr>\n
Every red eye in someone with lupus is caused by lupus.<\/td>\nNo. Infection, dry eye, allergy, glaucoma and other conditions can also cause redness, so a painful or persistent red eye needs appropriate assessment.<\/td>\n<\/tr>\n
Dry eye is the only eye problem associated with lupus.<\/td>\nDry eye is common, but lupus can also be associated with scleritis, retinal disease, vascular complications and rare optic-nerve or choroidal involvement.<\/td>\n<\/tr>\n
Hydroxychloroquine retinal toxicity will always cause symptoms early.<\/td>\nNo. Early retinal changes may develop before noticeable visual symptoms, which is why scheduled monitoring is important.<\/td>\n<\/tr>\n
You should stop hydroxychloroquine if you are worried about your eyes.<\/td>\nDo not stop prescribed hydroxychloroquine yourself. Concerns about retinal toxicity should be discussed with your prescribing and ophthalmology teams.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Can Lupus Cause Uveitis or Inflammation Inside Your Eye?<\/h2>\n

Uveitis is inflammation inside your eye and can cause redness, aching, blurred vision, light sensitivity or floaters. Although lupus can be associated with inflammatory eye problems, uveitis directly caused by active lupus appears to be uncommon.<\/p>\n

If you develop these symptoms, you should have your eyes assessed rather than assuming lupus is responsible. Untreated uveitis can sometimes lead to complications such as cataracts, raised eye pressure or damage to structures involved in vision.<\/p>\n

How Can Lupus Affect Your Retina?<\/h2>\n

Your retina is the light-sensitive layer at the back of your eye, and lupus can occasionally affect its small blood vessels. This may cause changes such as cotton-wool spots, small haemorrhages or reduced blood flow, although mild changes may not cause noticeable symptoms.<\/p>\n

More significant retinal inflammation or blood-vessel blockage can lead to blurred or reduced vision. Retinal involvement can sometimes occur alongside more active systemic lupus, so significant retinal findings may prompt your ophthalmology and rheumatology teams to review both your eyes and your wider disease activity.<\/p>\n

What Is Retinal Vasculitis?<\/h2>\n

Retinal vasculitis is inflammation of the blood vessels in your retina. If you have lupus, it is uncommon but can be serious because inflammation or blocked blood flow may affect how well your retina functions.<\/p>\n

You may notice blurred vision, missing areas in your visual field or a sudden reduction in sight. These symptoms need prompt ophthalmic assessment because retinal inflammation or reduced blood flow can sometimes threaten vision. Treatment may also need to address the underlying lupus, so your ophthalmologist and rheumatologist may work together.<\/p>\n

Can Lupus Cause Blood Vessel Blockages in Your Eyes?<\/h2>\n

If you have lupus, changes in blood vessels and blood clotting can sometimes affect the circulation in your retina. This risk may be higher if you also have antiphospholipid antibodies or antiphospholipid syndrome. A blocked retinal artery or vein can cause sudden changes in your vision, such as a dark patch, distortion or reduced sight in one eye.<\/p>\n

A retinal artery blockage can cause sudden, painless vision loss and requires emergency assessment. Other conditions, including high blood pressure, diabetes and cardiovascular disease, can also affect retinal blood flow, so your doctors may need to investigate the wider cause. If you suddenly cannot see from one or both eyes, go to A&E or call 999 rather than waiting to see whether your vision improves.<\/p>\n

Can Lupus Affect the Choroid?<\/h2>\n

The choroid is a layer of blood-vessel-rich tissue beneath your retina that helps supply it with oxygen and nutrients. Lupus can rarely affect this area, a condition sometimes called lupus choroidopathy, which may cause fluid to build up beneath the retina and lead to blurred or distorted vision.<\/p>\n

Because choroidal problems can be associated with more active systemic lupus, including kidney involvement or high blood pressure, your wider health may also need to be reviewed. Specialist retinal imaging can help identify these changes, while treatment usually focuses on controlling the underlying lupus rather than the visual symptoms alone.<\/p>\n

Can Lupus Affect Your Optic Nerve?<\/h2>\n

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Your optic nerve carries visual information from your retina to your brain. If you have lupus, inflammation or reduced blood supply can rarely affect this nerve and cause blurred or dim vision, reduced colour intensity or changes in your visual field.<\/p>\n

Your ophthalmologist may check your pupil reactions, colour vision, visual fields and optic nerve, with tests such as OCT or MRI considered when appropriate. Because several conditions can affect the optic nerve, new changes in your vision should be assessed promptly to reduce the risk of lasting visual damage.<\/p>\n

Can Lupus Affect Your Eyelids or the Area Around Your Eyes?<\/h2>\n

Lupus can sometimes affect the skin around your eyes and eyelids. These changes may also contribute to irritation or dryness.<\/p>\n