Ankylosing spondylitis (AS) is a rare form of inflammatory systemic arthritis that mainly affects the back. Because AS is a systemic condition, inflammation associated with it can affect other areas, including the eyes.

As with other types of arthritis, there is no cure for AS. Treatment focuses on relieving the symptoms, slowing the progression of the condition, and preserving the quality of life.

A person with AS should be aware of how it can impact their eyes and speak with their doctor if they have any eye issues.

Below, learn about some common conditions that a person with AS may experience and some general tips for supporting eye health.

Anterior uveitis, also known as iritis, is inflammation of a part of the eye called the uvea, which is located toward the middle of the eye.

Anterior uveitis is one of four types of uveitis — and the most common. It occurs toward the front of the uvea and affects the iris, the colored tissue.

According to one 2017 study, as many as 40% of people with AS develop acute anterior uveitis.

The HLA-B27 gene plays a role in the development of AS, and the same gene is associated with uveitis.

Without treatment, anterior uveitis may lead to permanent damage and possibly blindness. But with early treatment, a person’s prognosis is generally good.

Symptoms

Anterior uveitis causes swelling or inflammation in the eye. As the Spondylitis Association of America note, anterior uveitis causes:

  • pain
  • redness
  • light sensitivity
  • issues with vision

The symptoms generally affect one eye at a time, and they can take a few hours to a few days to develop. An episode of uveitis can last for as long as 6 weeks.

Treatment

Treatments can vary based on the severity of the condition. Anterior uveitis is commonly treated with corticosteroid eye drops and other drops to dilate the eye.

If drops do not work, the doctor may administer corticosteroid injections.

Treating the underlying AS with biologic drugs called tumor necrosis factor inhibitors can help prevent anterior uveitis.

Speak with a doctor about any symptoms of anterior uveitis. They may make a referral to an optometrist or ophthalmologist, who can rule out other possible conditions and administer treatment. If any symptoms do not improve, let the doctor know.

Glaucoma is actually a group of conditions that put pressure on the optic nerve. This can cause damage that leads to vision issues and potentially vision loss.

The Arthritis Foundation note that anyone with an inflammatory type of arthritis, such as AS, has an increased risk of glaucoma. Those who use corticosteroids also have a higher risk of these eye conditions.

Symptoms

A person typically does not have any symptoms in the early stages of glaucoma.

In later stages, the condition causes a slow loss of peripheral vision.

Without treatment, it can eventually cause blindness. Receiving treatment early can help prevent damage and preserve vision.

Treatment

There are three main types of treatment for glaucoma:

  • Medications: These are often eye drops, and they can help reduce pressure in the eye and prevent damage to the optic nerve.
  • Laser treatment: Doctors typically use this to help drain fluid from the eye and relieve pressure.
  • Surgery: This can help reduce pressure by draining fluid from the eye, if eye drops or laser treatment are not effective.

A person with AS should tell their doctor about any changes in vision. While glaucoma treatment cannot restore lost vision, early treatment can help prevent the issue from getting worse.

Cataracts causes the lens of the eye to become cloudy as a result of inflammation and pressure.

People who have genetic variations linked with inflammatory conditions, such as AS, have a higher risk of developing cataracts. In addition, taking steroids to treat health conditions can increase the risk of developing this eye problem.

Symptoms

Symptoms may not appear in earlier stages of cataracts. As the issue progresses, the symptoms may include:

  • cloudy or blurry vision
  • double vision
  • low night vision
  • colors appearing faded
  • sensitivity to light, from the sun, lamps, or headlights
  • lights seeming to have halos
  • a need for frequent changes in glasses prescriptions

Over time, cataracts can lead to vision loss.

Treatment

A person with AS should let their doctor know about any vision changes, which may result from cataracts.

An optometrist or ophthalmologist can diagnose the issue, provide treatment, and recommend management techniques. The plan may involve:

  • new glasses or contacts
  • small changes at home, such as having brighter lights or using magnifying devices when reading or working
  • surgery to remove the cloudy lens and replace it with an artificial lens

Anyone with AS should speak with their doctor about the risk of cataracts. An eye doctor can check for this issue during routine eye exams by dilating the eyes.

For people with AS, having regular eye checkups is important. It can help catch related eye conditions early and prevent damage or vision loss.

Let the doctor know about any changes in vision, including sensitivity to light, blurriness, or eye pain. These can be symptoms of an eye condition.

Receiving treatment early can help improve the prognosis for anterior uveitis and glaucoma.

AS is a systemic type of arthritis that primarily affects the back, but it can cause issues in other areas, including the eyes.

The most common eye condition associated with AS is anterior uveitis, but glaucoma and cataracts are also linked with this form of arthritis. Early detection and treatment can help preserve vision.