Ankylosing Spondylitis (AS)

Key aspects: Symptoms

1. Back pain and stiffness, especially in the morning or after rest
2. Limited spinal mobility and flexibility
3. Fatigue
4. Pain and stiffness in other joints, such as hips, shoulders, or knees
5. Eye inflammation (uveitis)

Causes and Risk Factors

1. Genetic predisposition (HLA-B27)
2. Autoimmune response
3. Environmental factors (e.g., infections)

Treatment

1. Medications: NSAIDs, biologics (e.g., TNF inhibitors), DMARDs
2. Physical therapy to maintain spinal mobility and strength
3. Lifestyle modifications: exercise, posture management, stress reduction

Complications

1. Spinal fusion and deformity
2. Osteoporosis
3. Cardiovascular disease
4. Respiratory problems

Ankylosing Spondylitis (AS) can have several ocular manifestations, including: 1. Uveitis (iritis or anterior uveitis): Inflammation of the uvea, leading to symptoms like: - Eye pain - Redness - Sensitivity to light (photophobia) - Blurred vision - Floaters 2. Conjunctivitis: Inflammation of the conjunctiva, causing redness, itching, and discharge. 3. Scleritis: Inflammation of the sclera, leading to severe eye pain and redness. 4. Episcleritis: Inflammation of the episclera, causing eye redness and discomfort. Key Points

• Uveitis is the most common ocular manifestation of AS.
• Ocular symptoms can precede or follow the onset of AS.
• Regular eye exams are crucial for early detection and management.

Management

• Treatment typically involves topical corticosteroids and mydriatics for uveitis.
• Systemic therapy may be required for severe or recurrent cases.
• Collaboration between rheumatologists and optometrists/ophthalmologists is essential for optimal care.

If one experiences any ocular and or systemic symptoms, seek medical attention promptly to prevent complications. Early diagnosis and treatment can help manage symptoms, slow disease progression, and improve quality of life.

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Author

Paddy Kalish OD, JD and B.Arch Author and Blogger