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Symptoms and Signs of Eye Problems Caused by Ankylosing Spondylitis

Doctor's Notes on Eye Problems Caused by Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a type of progressive arthritis that primarily affects spine and the related ligaments and joints. It can also affect other joints and organs in the body, including the eyes, lungs, kidneys, shoulders, knees, hips, heart, and ankles. About one-third of ankylosing spondylitis patients develop an eye condition called anterior uveitis, which is an inflammation of the front part of the eye called the uvea, including the iris and ciliary body.

Eye symptoms caused by ankylosing spondylitis usually develop over a few hours. Anterior uveitis associated with ankylosing spondylitis may occur in one eye or both eyes and tends to recur. Symptoms of anterior uveitis associated with ankylosing spondylitis may include eye redness, light sensitivity (photophobia), tearing, eye pain which is described as being deep and is made worse by bright light, and blurred vision. Rarely, there is discharge from the eyes.

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 3/11/2019

Eye Problems Caused by Ankylosing Spondylitis Symptoms

The symptoms of anterior uveitis may include eye redness, light sensitivity (photophobia), tearing, eye pain, and blurred vision. Discharge from the eyes is uncommon. The eye pain associated with anterior uveitis is described as being deep and is made worse by bright light.

Eye symptoms usually develop over a few hours. Anterior uveitis associated with ankylosing spondylitis may occur in one eye or both eyes and tends to be recurrent.

Diagrams of the eye.
Diagrams of the eye. Click to view larger image.

Eye Problems Caused by Ankylosing Spondylitis Causes

Ankylosing spondylitis (AS) is a type of progressive arthritis that leads to chronic inflammation of the spine and the area where the spine joins the pelvis (sacroiliac joints). Ankylosing spondylitis primarily affects the axial skeleton (skeleton of the head and trunk) and the related ligaments and joints. Ankylosing spondylitis can also affect other joints and organs in the body, including the eyes, lungs, kidneys, shoulders, knees, hips, heart, and ankles.

The term ankylosing spondylitis refers to stiffening and inflammation of the spine. Ankylosing spondylitis causes stiffness, aching, and pain around the spine and pelvis. The spine stiffens because of inflammation of the joints between the bones of the spine. This inflammation can cause the vertebrae to fuse together and eventually can lead to a total fusion of the spine. This fusion occurs when the vertebrae (spinal bones) actually grow together, fusing the spine due to calcification of the ligaments and disks between the individual vertebrae. If the vertebrae fuse together, the spine loses its mobility, leaving the vertebrae brittle and vulnerable to fractures. Ankylosing spondylitis may also cause a curvature of the spine.

Ankylosing spondylitis is often referred to as a form of inflammation of the bony spine called seronegative spondyloarthropathy. In the case of ankylosing spondylitis, the term seronegative means that blood tests do not show the presence of certain factors seen with rheumatoid arthritis. The term spondyloarthropathy means a disease that affects the joints of the spine.

Ankylosing spondylitis primarily affects young adults and is more common in males than in females. This disease is also more common in Caucasians than in African Americans. The onset of ankylosing spondylitis is most common in men 17-35 years of age. In women, the symptoms of ankylosing spondylitis often first appear during pregnancy.

About 30% of people with ankylosing spondylitis develop anterior uveitis sometime in the course of their disease. Anterior uveitis is an inflammation of the front part of the eye called the uvea, including the iris and ciliary body.

The cause of anterior uveitis is unknown; however, the immune response associated with ankylosing spondylitis that causes the spinal problems is most likely similar to the inflammation seen with anterior uveitis.

Many other possible causes of anterior uveitis exist, but when ankylosing spondylitis is present, the development of anterior uveitis is most likely related to ankylosing spondylitis.

Ankylosing Spondylitis Symptoms, Diagnosis, and Treatment Slideshow

Ankylosing Spondylitis Symptoms, Diagnosis, and Treatment Slideshow

Ankylosing spondylitis (AS) is a type of arthritis that inflames the joints (vertebrae) in the spine. The most commonly affected part of the spine in the sacroiliac (SI) joint. This is the joint where the spine connects with the pelvis. The condition affects other joints in the body in some cases including the ribs, shoulders, knees, hips, and feet. The condition causes pain, stiffness, and discomfort along the length of the spine. Rarely, AS involves the bowel, eyes, lungs, and heart. Many people who have AS have mild, intermittent pain. Some have constant, severe pain. Some people experience a loss of flexibility in the spine due to AS.

Spondylitis means inflammation of the spine. Ankylosis is when bones fuse together. When vertebrae become inflamed and fuse together, the condition is called ankylosing spondylitis. AS is a type of spondyloarthropathy. Spondyloarthropathies are chronic, long-term joint diseases. The spondyloarthropathies include AS, psoriatic arthritis, reactive arthritis, and enteropathic arthritis, a type of arthritis that sometimes occurs in people who have inflammatory bowel disease. The most common symptom of spondyloarthropathy is lower back pain. Spondyloarthropathies have a tendency to run in families. Another name for spondyloarthropathies is spondyloarthritis. This refers to inflammatory conditions that involve the joints and the entheses (areas were tendons and ligaments attach to bones). Spondarthropathies may mimic rheumatoid arthritis in a variety of ways. However, spondarthropathies do not feature rheumatoid factor, antibodies that are present in many people who have rheumatoid arthritis.

Spondyloarthropathies are grouped into two main classes. Axial spondyloarthritis is inflammation of the spine and sacroiliac joints. Peripheral spondyloarthropathritis is inflammation that affects the peripheral joints.

Other less common names for ankylosing spondylitis are Marie Strümpell disease and Bechterew disease.

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.

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