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The Science of Ulcerative Colitis
Content created by Medical News Today and supported by advertising. Learn more


HOW ULCERATIVE COLITIS CAN AFFECT THE EYES


Medically reviewed by Youssef (Joe) Soliman, MD — Written by David Rossiaky on
May 13, 2024
 * Eye conditions
 * Diagnosis
 * Treatment
 * Medication
 * Contacting a doctor
 * Summary

Ulcerative colitis (UC) is a type of inflammatory bowel disease (IBD). The
underlying inflammation of UC can lead to eye conditions such as scleritis and
uveitis. Without treatment, some conditions may lead to vision loss.

UC is a chronic condition that primarily affects the large intestine. It is a
type of IBD, meaning that inflammation is generally the cause of most of its
symptoms. These include urgent bowel movements, bloody stool, and abdominal
pain.



Many of the typical symptoms of UC directly involve the gastrointestinal tract,
but they can also affect other parts of the body, such as the joints, bones,
muscles, skin, or even the eyes.

This article discusses which eye conditions can link to UC, possible treatments,
and when it might be time to talk with a doctor.


EYE CONDITIONS LINKED TO ULCERATIVE COLITIS

Some eye conditions might directly result from UC, while others could be more
indirect secondary effects.

Although the exact cause of UC is not known, it is currently understood to be an
immune-mediated disease. This means that the immune system mistakenly attacks
healthy tissue in the gut, causing inflammation that leads to symptoms of UC.
Sometimes, this same immune response can cause inflammation in other areas,
potentially leading to the eye conditions listed below.


SCLERITIS

Scleritis, as with UC, is an inflammatory condition. It affects the sclera,
which people commonly refer to as the whites of the eyes.

Scleritis causes pain and inflammation that worsens with eye movement,
particularly at night. There are two main types: anterior scleritis, which
affects the front of the eye, and posterior uveitis, which affects the back of
the eye.

If left untreated, scleritis may lead to permanent vision lossTrusted Source due
to inflammation and damage to other areas of the eye.

Treatment for scleritis might include:

 * steroid eye drops
 * corticosteroid pills
 * nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen
 * oral antibiotic or antiviral medication
 * immunosuppressive and immunomodulatory drugs (used for severe conditions to
   prevent or alter the immune system response)

In severe cases, surgery might be the best option to repair the eye and prevent
further vision loss.


EPISCLERITIS

Episcleritis is an inflammatory condition that affects the episclera, a thin
layer of tissue that wraps around the sclera. Between 26% to 36%Trusted Source
of people with episcleritis also have a systemic disorder, one of which can be
UC.

Symptoms of episcleritis are generally mild, such as eye redness or discomfort.
It will often resolve on its own within 2 to 21 daysTrusted Source. If treatment
is required, it can be administered at home and could include:

 * a topical corticosteroidTrusted Source such as fluorometholone or loteprednol
   etabonate
 * corticosteroids
 * NSAIDs
 * anti-inflammatory eye drops


UVEITIS

Uveitis is another type of inflammation in the eyes. It affects the uvea, or the
middle layer of the eye, which consists of several layers. UveitisTrusted Source
can result from an infection or an autoimmune condition, such as UC.

Common symptoms include red eyes, pain, blurriness, and light sensitivity.
Uveitis is typically treatable but can cause vision loss if not properly
addressed.

Treatment typically involves steroids to reduce inflammation. These may consist
of eye drops, pills, or injections. If the symptoms do not respond to treatment,
surgery might be an option. This is where a surgeon places a small implant in
the eye, which releases small amounts of a steroid over time.


OPTIC NEURITIS

The optic nerve sits at the back of the eye and converts incoming light into
electrical signals for the brain to interpret. Optic neuritis occurs when the
optic nerve becomes inflamed. This inflammation can damage the myelin sheath,
the protective coating around the optic nerve, which may lead to vision loss or
impairment.

Symptoms of optic neuritis often include:

 * blurred vision
 * dim vision
 * colors appearing dull and washed out
 * pain at the back of the eye socket
 * pain with eye movement

Treatment is not always necessary. It often depends on the type of optic
neuritis a person has and how it has affected them. If treatment is needed,
options may include:

 * over-the-counter pain medication
 * intravenous or oral steroids
 * immunosuppressants


RETINAL CONDITIONS

A variety of conditions can affect the retina, the layer of cells lining the
back wall inside the eye. The retina converts light into electrical signals that
are sent to the brain so people can see. People over age 55 with IBD may have an
increased risk of retinal conditions compared with people who do not have IBD.

One such retinal condition is retinal pigment epithelial detachment (PED)Trusted
Source. This occurs when the retinal pigment epithelium layer of the eye
separates from the inner layer of the Bruch’s membrane. The space between these
layers can fill with blood or other materials.

PEDs may not always cause any obvious symptoms or can lead to blurry vision. The
treatment options will depend on the exact location and nature of the tear but
may include:

 * antivascular endothelial growth factor (VEGF) injectionsTrusted Source
 * laser photocoagulationTrusted Source
 * photodynamic therapyTrusted Source


DRY EYE SYNDROME

Dry eye syndrome, more often known as dry eyes, is an extremely common condition
with a wide range of possible symptoms and levels of severity.

For people with UC, dry eyes could be a secondary effect stemming from other eye
conditions such as uveitis. Treatment options may include:

 * artificial tears
 * anti-inflammatory eye drops, such as cyclosporine or lifitegrast
 * tear duct plugs

A person’s doctor might also suggest lifestyle changesTrusted Source such as:

 * avoiding smoke, wind, and air conditioning
 * using a humidifier at home
 * reducing screen time or taking frequent breaks from screens
 * using wraparound sunglasses outdoors
 * staying hydrated
 * maintaining a good sleep schedule

Surgery is not often required for dry eye but might be necessary if the lower
eyelids are too loose, as this can cause tears to drain too quickly out of the
eye. If surgery is necessary, a doctor will repair the eyelids to help keep the
tears in the eye.


CONJUNCTIVITIS

The conjunctiva is the membrane that covers the inside of the eyelids. The term
for inflammation in this area is conjunctivitis, more commonly known as pink
eye.

There are many possible causes of conjunctivitis. While there is no demonstrated
causal link between conjunctivitis and UC, it can sometimes be a secondary
effect due to the other possible eye conditions connected to UC.

Most cases are mild and will eventually clear on its own. Some cases of viral
conjunctivitis can take 2 to 3 weeksTrusted Source to resolve. A doctor might
prescribe antiviral medication for severe cases.

Bacterial conjunctivitis is often treated with antibiotics, especially if there
is any pus or certain types of bacteria. If the person with pink eye is
immunocompromised, they may also receive antibiotic treatment.

For allergic conjunctivitis, a doctor might suggest allergy medication, eye
drops, or a combination of drugs.


HOW ARE EYE CONDITIONS DIAGNOSED IF A PERSON HAS UC?

UC can cause a variety of eye conditions, either directly or indirectly. Some
will have more obvious and immediate symptoms, while other conditions, such as
glaucomaTrusted Source, can occur without vision loss until they are very
advanced.

An ophthalmologist can diagnose symptomatic eye conditions when they occur and
may be able to detect asymptomatic eye conditions during routine checkups. If a
person has UC, it may be useful to share this information with their
ophthalmologist to receive more specialized care.



HOW ARE EYE CONDITIONS TREATED IF SOMEONE HAS UC?

Treatment will depend on the person’s eye condition. In some cases, home
treatments such as NSAIDs, cold compresses, and eye drops may be adequate. In
the most severe cases, surgery may be necessary to repair damage and avoid
vision loss.

If a person has an eye condition due to UC, their doctor can help devise a
treatment plan that fits their needs.



CAN UC TREATMENT OR MEDICATION AFFECT THE EYES?

Many treatment options for UC include medication to reduce inflammation.
Inflammation is frequently associated with the eye conditions covered above, so
these medications could also potentially help to prevent inflammation in and
around the eyes. The types of medications include:

 * aminosalicylates
 * corticosteroids
 * immunosuppressants
 * biologics
 * Janus kinase (JAK) inhibitors

This is still an active area of research.

For eye conditions related to UC, reducing inflammation can help ease a person’s
symptoms and potentially help prevent vision loss.

Some medications used to treat UC may be associated with eye complications.
Long-term use of corticosteroids, for example, may cause:

 * cataracts, cloudy areas in the lens of the eye that can impair vision
 * glaucoma, a group of eye conditions that damage the optic nerve

People with UC should talk with their doctors about possible eye health risks
associated with their medication.

WHEN TO CONTACT A DOCTOR

There are many eye conditions a person might experience if they have UC. Some
conditions are mild, but others can lead to permanent vision loss or eye damage.

If the person is experiencing pain, irritation, excessive redness, or visual
impairment such as blurriness, it might be best to have a doctor check their
eyes. Symptoms will not necessarily line up with UC flare-ups.

Even if a person is not experiencing any symptoms, it is still important to
visit an eye doctor for an annual checkup.


SUMMARY

The exact cause of UC is unknown, but inflammation plays an important role. That
same inflammatory response can also lead to several eye conditions with varying
degrees of severity.

People with UC may want to ask their doctors for more information about the eye
conditions that can affect them and how to manage their symptoms.


 * Uncategorized


HOW WE REVIEWED THIS ARTICLE:

Sources
Medical News Today has strict sourcing guidelines and relies on peer-reviewed
studies, academic research institutions, and medical journals and associations.
We only use quality, credible sources to ensure content accuracy and integrity.
You can learn more about how we ensure our content is accurate and current by
reading our editorial policy.
 * Boyd K. What Is optic neuritis? (2023).
   https://www.aao.org/eye-health/diseases/what-is-optic-neuritis
 * Common eye disorders and diseases. (2023).
   https://www.cdc.gov/visionhealth/basics/ced/index.html
 * Conjunctivitis (pink eye). (2021).
   https://www.cdc.gov/conjunctivitis/index.html
 * Dang S, et al. (2022). Estimating lifetime risk of retinal disorders among
   patients with IBD above age 55 years.
   https://iovs.arvojournals.org/article.aspx?articleid=2780964
 * Dry eye. (2023).
   https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/dry-eye
 * Duplechain A, et al. (2023). Uveitis.
   https://www.ncbi.nlm.nih.gov/books/NBK540993/
 * Episcleritis. (2021).
   https://mft.nhs.uk/app/uploads/sites/2/2019/05/REH-161.pdf
 * Fact sheet: Eye complications. (2015).
   https://www.crohnscolitisfoundation.org/sites/default/files/legacy/assets/pdfs/eyes.pdf
 * Golden MI, et al. (2023). Dry eye syndrome.
   https://www.ncbi.nlm.nih.gov/books/NBK470411/
 * Guier CP, et al. (2023). Optic neuritis.
   https://www.ncbi.nlm.nih.gov/books/NBK557853/
 * Gurnani B, et al. (2023). Iritis.
   https://www.ncbi.nlm.nih.gov/books/NBK430909/
 * Hashmi MF, et al. (2024). Conjunctivitis.
   https://www.ncbi.nlm.nih.gov/books/NBK541034/
 * Hsieh YH, et al. (2021). Association between optic neuritis and inflammatory
   bowel disease: A population-based study.
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916645/
 * Inoda S, et al. (2019) Half-dose photodynamic therapy for serous
   non-neovascular retinal pigment epithelial detachment.
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6561329/
 * Javaheri M, et al. (2020).
   https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2774251
 * Karampelas M, et al. (2020). Retinal pigment epithelial detachment in
   age-related macular degeneration.
   https://link.springer.com/article/10.1007/s40123-020-00291-5
 * Koçak N, et al. (2019). Demarcation laser photocoagulation for subclinical
   retinal detachment: Can progression to retinal detachment be prevented?
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961077/
 * Lagina A, et al. (2023). Scleritis.
   https://www.ncbi.nlm.nih.gov/books/NBK499944/
 * Lee HJ, et al. (2017). Ophthalmologic manifestations in patients with
   inflammatory bowel disease.
   https://irjournal.org/journal/view.php?doi=10.5217/ir.2017.15.3.380
 * Lynch WD, et al. (2023). Ulcerative colitis.
   https://www.ncbi.nlm.nih.gov/books/NBK459282/
 * Optic neuritis. (2022).
   https://www.rnib.org.uk/your-eyes/eye-conditions-az/optic-neuritis
 * Pytrus W, et al. (2022). A review of ophthalmic complications in inflammatory
   bowel diseases.
   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781961/
 * Schonberg S, et al. (2023). Episcleritis.
   https://www.ncbi.nlm.nih.gov/books/NBK534796/
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   https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/uveitis
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Medically reviewed by Youssef (Joe) Soliman, MD — Written by David Rossiaky on
May 13, 2024


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