Persons with Relapsing Polychondritis may have ocular muscle palsies or optic neuritis. Peripheral ulcerative keratitis has been found in patients and has been associated with perforation, endophthalmitis, and bilateral enucleation. Papilledema, visual field defects, ptosis, lid retraction, proptosis and cataracts also may be found on exam.
Episcleritis, scleritis, iritis or keratoconjunctivitis sicca occur most often. Proptosis presumably results from inflammation in the posterior elements of the globe, such as choroiditis, or adjacent cartilage inflammation in the nasal septum. Posterior and subcapsular cataracts frequently form and may be a consequence of chronic inflammation or may reflect cumulative steroid exposure.
The severity of nongranulomatous uveitis may parallel disease activity in there organ systems.
Topical steroid therapy generally does not curtail ocular manifestations in RPC; thus, systemic steroid therapy may be necessary and/or Immunosuppressive agents.
One of the most constant features of Relapsing Polychondritis (RPC), ocular inflammation, can affect almost any part of the eye. Ocular involvement affects 22 percent of persons at presentation. During the course of the disease 54 to 60 percent of persons with RPC may develop some type of eye disease. Acute or chronic eye inflammation may be mild or severe and can reduce vision or cause blindness. Persons usually develop eye disease related to episodic inflammation of the uveal tract, conjunctivae, sclera and/or cornea.
When presenting early in the course of the disease or when it is an isolated symptom, ocular inflammation offers little to specifically suggest the diagnosis of RPC. When eye and joint symptoms co-exist, the condition may be misdiagnosed as reactive arthritis or spondyloarthropathy. Collagen types; II, IX and XI, which are present in cartilage, are also found in the cornea and sclera. Autoantibodies to these collagens, found in some relapsing polychondritis patients, may be responsible for direct harm to the eyes.
