If you have Crohn’s disease, you’re probably all too familiar with the unpleasant gastrointestinal (GI) system like tarry poop and stomach pains. But what about symptoms in *other* parts of your body?
Some folks might experience sensitivity to light during a flare-up. But can your gut actually mess with your vision? Is there a link between Crohn’s disease and your eyes? It turns out, your body parts might be more interconnected than you think.
Does Crohn’s disease affect your eyes?
The Crohn’s & Colitis Foundation estimates that approximately 10 percent of Crohn’s Disease patients develop related eye complications. This is considered an “extraintestinal” symptom of the illness because it occurs outside your GI system.
A doctor or ophthalmologist can help diagnose your eye condition and determine whether it’s linked to Crohn’s Disease.
For some folks, yes!
Crohn’s is classified as an inflammatory bowel disease (IBD). But anywhere from 25 to 40 percent of people living with it also experience complications outside the gut. Some of those complications can cause symptoms like eye inflammation and irritation.
Wondering how a GI issue could affect your eyes? Science says there’s a couple of reasons.
- Disease activity. Crohn’s Disease is an inflammatory condition without a specific known cause. But if your body is inflamed in one place — your GI system — it’s possible for that issue to impact other parts of your bod.
- Crohn’s treatments. Experts say that sometimes the meds used to treat your GI illness can trigger side effects in your eyes. For instance, steroids are known to raise your risk for cataracts (cloudy spots on the lens of your eye).
All it takes is a wayward eyelash to remind you that your peepers are super sensitive. The upside to that touchiness? Eye irritation can sometimes clue you in to more serious health conditions. Here are some of the eye diseases that could be related to Crohn’s.
According to a 2016 research review, episcleritis and uveitis are the most common Crohn’s-related eye disorders. Episcleritis = inflammation of the episclera, which is a thin layer between the very top of your eye and the white part. Episcleritis can affect one or both eyes.
Look for symptoms like:
- bright red spots on the whites of your eye(s)
- watery eyes with no discharge
- mild eye irritation
Uveitis = painful swelling of the tissue just under the whites of your eyes. Left unchecked, it can lead to glaucoma and vision loss.
Signs of uveitis include:
- eye pain
- blurry vision
- sensitivity to light
- seeing floaters
- eye redness
Symptoms may appear gradually, so pay attention if your vision seems to be getting worse week after week.
The sclera is the white layer sandwiched between your episclera and uvea. When this layer gets irritated, it’s called scleritis.
Here are the signs:
- red, watery eyes
- eye pain or burning
- blurry vision
- sensitivity to light
- trouble sleeping
There’s an interesting link between scleritis and other nonintestinal symptoms of Crohn’s Disease. Let’s rewind to 2012 for a sec: In a study of 500 people with scleritis, those who had IBD *also* tended to have arthritis, which is another common complication of Crohn’s disease.
If you suspect scleritis, talk with an eye doctor ASAP. Severe, untreated flares can eventually lead to thinning of the sclera.
This eye disorder affects your cornea, which is the transparent layer that covers the top of your eye.
Keratopathy = cornea damage. It can lead to painful blistering and swelling. It’s not the most common Crohn’s-related eye disease, but it still happens. Sometimes uveitis or dry eyes can trigger this type of corneal damage too.
Symptoms of keratopathy:
- light sensitivity
- feeling like there’s something stuck in your eye
- watery eyes
Bad news: Keratopathy is a pain. Good news: It’s considered mild and doesn’t lead to lasting damage. Think of it as a blister on your foot. Painful? Yep. Deadly? Absolutely not.
A small study of 61 Crohn’s patients found that 35 of them experienced eye dryness. Of course, teensy studies like this aren’t big enough to draw conclusions about the general population. But it’s still worth noting since over half of the people had this symptom.
Signs of dry eyes (aka keratoconjunctivitis sicca) include:
- sandpaper-like irritation
- feeling like there’s something in your eye
Dry eyes happen when your eyes don’t have enough lubrication. Maybe you’re not making enough tears. Maybe your tears aren’t oily enough. Or maybe your Crohn’s disease keeps your body from absorbing eye-loving nutrients like vitamin A. No matter what the cause of the issue is, your doc can help you find a treatment that works for you.
This optic nerve flare-up can spell bad news for your vision. But it’s a really rare side effect of IBD.
Your optic nerve is a bit like a speedy Wi-Fi connection from your eyes to your brain. It helps translate color and light into the solid objects you see around you. When it’s irritated or inflamed, messages get a little fuzzy.
Signs of optic neuritis include:
- poor vision
- blurry vision, especially when you’re overheated
- seeing colors more dimly than usual
- trouble seeing out of one eye
- eye pain, particularly when moving it up and down or side to side
Optic neuritis varies from person to person. For some folks, it clears up on its own. For others, it could lead to permanent damage. If you’re experiencing symptoms of optic neuritis, talk with your doctor right away.
Other potential complications
Remember, sometimes the meds you’re taking to treat Crohn’s have eye-related side effects. According to the Irwin M. Suzanne R. Rosenthal IBD Resource Center, regular use of corticosteroids could potentially lead to:
- impaired vision
Of course, this does NOT mean you should throw out your treatment plan! Never self-diagnose or self-wean from your meds. It could trigger a flare-up, which will only make things worse.
If you’re concerned about side effects from your meds, talk with your doctor.
If you have Crohn’s and notice a change in your vision or pain in your eyes, it’s time to talk with your primary care provider or eye doctor. They’ll probably ask several questions about your symptoms and suggest a special eye exam.
Getting your eyes checked for Crohn’s-related eye issues usually involves a slit lamp. Basically, it’s a super-bright light and microscope that lets your doc see deep into your peepers.
If your doctor suspects corneal damage, they might do a dye test where they drip magical damage-highlighting orange stuff into your eyes. (“GoldenEye,” anyone?)
The key to pinpointing the cause of your eye issues is transparency. Thoroughly explain what’s going on with your vision. Unpack your Crohn’s history and any other pain or extraintestinal symptoms you’re experiencing.
Your treatment will depend on the type and severity of your eye condition.
Work with your primary care doctor or ophthalmologist to figure out the problem before you troubleshoot with any solution beyond a cool washcloth or over-the-counter eye drops.
Curious about common treatments?
- Episcleritis. This is usually treated with eye drops and cold compresses. More severe cases might require prescription eye drops or ointments.
- Uveitis. Most ophthalmologists treat uveitis with prescription meds or surgery.
- Keratopathy. Mild cases of keratopathy usually clear up with eye drops or medicated eye ointment. Some cases only respond to stronger medication, special contact lenses, or eyelid injections.
- Scleritis. Your treatment will depend on the intensity and type of scleritis. Options range from prescription eye drops to systemic meds that tackle your body’s rebellious immune response.
- Optic neuritis. Most cases resolve on their own. But when the problem is severe or lingering, docs might prescribe relevant IV meds, injections, or corticosteroids.
- Dry eyes. Your doc might recommend eye drops, a warm compress, or getting tested for a vitamin deficiency.
Can you lower your risk for Crohn’s-related eye problems?
Maybe! Like anything else, an ounce of prevention is worth a pound of cure. When you do what you can to manage your disease, you could also reduce your risk of optical side effects.
Do your best to prevent a flare-up by avoiding common Crohn’s triggers like:
- Though Crohn’s disease is gastrointestinal, about 10 percent of folks living with the condition also develop eye problems.
- Some medicines used to treat Crohn’s disease can cause side eye-related effects.
- Most of these eye problems are easy to treat — especially if you catch them early!
- Schedule regular eye exams so your doctor can identify problems before they progress too far.
- If you have Crohn’s disease and develop severe pain or sudden symptoms in any other part of your body, call your doctor.