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ARTHRITIS

AND
CONNECTIVE TISSUE DISORDER
AND
EYE
Vajja Swathi
11/11/2015

Topics
Arthritis
Anatomy and Pathophysiology of
Arthtritis
Connective tissue disorders and eye

ARTHRITIS
Joint disorder
Inflammation of one or more
joints
More than 100 different types

ETIOLOGY
Age
Metabolic
Infection
Auto immune
Biomechanical stress obesity, joint
dislocation and instability, muscle
strain
Injury

Normal Joint

Arthriti
s

Classification of Arthritis
Degenerative arthritis
Osteoarthritis

Autoimmune arthritis
Rheumatoid arthritis
ANA positive diseases

Infectious arthritis
Bacterial
Viral

Metabolic / endocrine
Hyperthyroidism
Hyperparathyroidism

Crystalline arthritis
Gout
Pseudo gout

Neoplastic arthritis
Primary
Para neoplastic

Monoarthrit
is

Polyarthritis

Osteoarthritis

Rheumatoid Arthritis

Gouty Arthritis

Septic Arthritis

Sclera is dense fibrous connective tissue


Continuation of substantia propria of cornea

RHEUMATOID ARTHRITIS
Dry eye (discomfort,
burning sensation)
Scleritis (necrosis of the
sclera may occur)

Scleritis

Episcleritis

Episcleritis
Corneal ulceration
Uveitis

Corneal
ulceration

ANKYLOSING SPONDYLITIS
Occurs in younger patients with HLA B27
positivity, causes sacroiliitis
Recurrent anterior uveitis

REITERS SYNDROME
Reactive Arthritis, Ocular inflammation ,
urethritis
The causative agents :Chlamydia, Yersinia,
Salmonella

JUVENILE IDIOPATHIC
ARTHRITIS
Children with inflammatory
arthritis under
12 years of age are at risk

Low grade iritis, that may lead to blindness


COMPLICATIONS:
Cataract
Glaucoma
Band keratopathy

OCHRONOSIS

Degenerative
arthritis
resulting
alkaptonuria
(genetic
defect
of
homogentisic acid oxidase system)

from
the

Excess homogentisic acid is deposited in the


large joints & polymerises (turns black)
Ochronotic spondylitis presents in the fourth
decade

Homogentisic acid is also deposited in other


tissues.
The extra-articular manifestations
ocular & skin pigmentations,
genito-urinary calculi &
cardiovascular ochronosis, (especially
aortic valve).

the

SYSTEMIC LUPUS
ERYTHEMATOSUS
Dry eyes
Scleritis
Peripheral corneal ulcers
Retinopathy
Optic neuropathy

WEGENER
GRANULOMATOSIS
Respiratory System , arthritis, eye
symptoms
16% of cases only present ocular
involvement:
Marginal ulcerative keratitis
Conjunctivitis and episcleritis
Anterior and posterior scleritis
Granulomatous anterior uveitis
Retinal vasculitis
Optic neuritis
Orbital infiltration