ESCRS - POCOR544 - Reversible Visual Loss In Rheumatoid Arthritis: Ocular Surface Optimization As A Primary Visual Rehabilitation Strategy

Reversible Visual Loss In Rheumatoid Arthritis: Ocular Surface Optimization As A Primary Visual Rehabilitation Strategy

Published 2026 - 44th Congress of the ESCRS

Reference: POCOR544 | Type: Poster | DOI: 10.82333/hpsh-ss96

Authors: Dr Ahmed Safie Eldeen* 1

1Ophthalmology,Hazem Yassin Eye Clinic,Cairo,Egypt;Cornea and refractive department,Almashreq Eye Center,Cairo,Egypt;Ophthalmology,Ahmed Safieldin Eye Care Clinic,Suez,Egypt

Purpose

To demonstrate the impact of severe autoimmune dry eye on visual acuity and the role of ocular surface stabilization as a primary step in visual rehabilitation

Setting

Private ophthalmology practice, Egypt

Methods

Interventional case report.

A patient with known rheumatoid arthritis presented with a progressive decrease in vision not explained by refractive error or media opacity.

Clinical evaluation included:

  • Slit lamp examination
  • Tear film assessment
  • Corneal surface evaluation with fluorescein staining

Findings revealed severe ocular surface disease characterized by marked tear film instability and diffuse punctate epithelial erosions.

The patient was treated with:

  • Preservative-free artificial tears (frequent dosing)
  • Topical cyclosporine A 0.05% and a short course of topical corticosteroid

No refractive correction or surgical intervention was performed.

Results

Pre-treatment best corrected visual acuity (BCVA): 0.5

After ocular surface optimization:

  • Marked reduction in epithelial erosions

  • Improved tear film stability

  • BCVA improved to 1.0

Visual recovery correlated with restoration of corneal surface regularity rather than refractive change.

Conclusions

Severe autoimmune dry eye may cause significant yet reversible visual loss mimicking refractive or media pathology.

Ocular surface optimization should be considered a primary visual rehabilitation step before planning refractive or cataract intervention in patients with systemic autoimmune disease.

Failure to recognize this may lead to unnecessary surgical procedures and inaccurate biometric measurements.