- Rheumatoid arthritis is the most common systemic, immune-mediated disease affecting the ocular surface.
- Primarily affects middle age females.
- Episcleritis or scleritis
- Mild superficial punctate keratitis or severe sclerosing keratitis
- Peripheral corneal infiltrates which may progress to marginal furrowing, thinning or melting
- Keratoconjunctivitis sicca (secondary Sjorgen syndrome)
- Treatment is addressed primarily to the systemic condition.
- Systemic and topical corticosteroids are useful for ocular inflammation.
- Aggressive ocular surface lubrication and/or punctal plug for keratoconjunctivitis sicca.
- Cyanoacrylate adhesive for severe corneal melting.
- Lamellar or penetrating keratoplasty for perforation.