Which ocular manifestation is associated with rheumatoid arthritis?

• A. Uveitis
• B. Scleritis
• C. Retinopathy
• D. Scleromalacia perforans

Answer: (D)

Rheumatoid arthritis can involve the eyes in several ways, but the finding most characteristic of RA among these options is a late, painless thinning of the sclera known as scleromalacia perforans. This form represents necrotizing inflammation of the sclera with progressive thinning, which can progress to perforation. It tends to occur in long-standing, seropositive RA and may present with little or no eye pain, distinguishing it from more typical, painful scleral inflammation (scleritis) and from other eye issues.

Uveitis is more commonly linked to other autoimmune diseases and is not a classic RA hallmark. Retinopathy can occur in various conditions but isn’t a defining RA ocular manifestation. Scleritis can accompany RA, but scleromalacia perforans is the specific scleral thinning disorder most closely associated with RA, making it the best match.