Typical questions from the rheumatologist to the ophthalmologist and cooperating radiologist

Patients with rheumatic disorders may suffer from various acute or chronic ocular symptoms. In addition to pain and motility disorders, loss of vision, and irreversible deterioration of the eye may occur. Red eye, a symptom easily identified, can be a sign of rheumatic involvement, but can also have a variety of other causes. Dry eye is frequently present in rheumatic patients. It is always important that infections and masquerade syndromes are ruled out in the differential diagnoses of any ocular inflammation. In cases of ocular inflammation the ophthalmologist should determine the diagnostic procedure on the basis of his clinical experience. Uveitis is a common complication of juvenile idiopathic arthritis depending on the subtype of arthritis. Patients with episcleritis rarely suffer from systemic inflammation, while inflammation is found in half of all cases of scleritis. Corneal ulceration should always be managed as an emergency case and, in addition to systemic medication, surgical intervention is often indicated. The degree of orbital or ocular involvement can be objectively monitored using modern imaging techniques. Medications against rheumatic inflammation may rarely result in ocular side effects, which should be detected early by the eye specialist.