Although inflammatory bowel syndrome (IBS) mainly affects digestion and abdominal health, inflammation associated with this disorder can also affect tissues in the eyes, leading to vision problems. (Learn More)

There are several potential eye problems associated with inflamed tissues, from conjunctivitis to optic nerve damage. (Learn More) People with IBS are also at higher risk of developing chronic dry eye. (Learn More)

Because of tissue inflammation, poor healing, and the higher risk of dry eye, LASIK is not recommended for people with IBS. (Learn More)

Treatment for IBS is often corticosteroids, which can increase the risk of cataracts. Fortunately, many people who have cataract surgery have good outcomes. (Learn More)

How Does Inflammatory Bowel Syndrome Affect the Eyes?

Inflammatory bowel syndrome (IBS) is a term that actually covers two medical conditions: Crohn’s disease and ulcerative colitis. Both of these chronic illnesses involve inflammation of the gastrointestinal tract, which can be quite painful.

Prolonged inflammation can cause damage to the stomach and intestines. Crohn’s disease typically affects the small intestine, while ulcerative colitis affects the large intestine.

While most symptoms involve digestion and the abdomen, IBS can also have an effect on your vision. Treatments for this condition, especially corticosteroids, may also cause problems with your eyesight.

These are the most common symptoms associated with IBS:

  • Persistent diarrhea
  • Abdominal pain
  • Weight loss
  • Fatigue

The cause of IBS is not known, but both conditions associated with IBS seem to involve the immune system attacking the gastrointestinal tract, which causes inflammation.

There are several treatments for IBS, one of which is corticosteroids like prednisone. Again, these treatments can have negative effects on the eyes.

Eye Problems Associated With IBS

Since IBS is a chronic condition, there are some potential impacts on other parts of the body, including the eyes. These include the following:

  • Light sensitivity
  • Dry eyes
  • Painful, red eyes (uveitis)

One survey found that eye problems occurred in 4 to 10 percent of people with IBS and seemed to be more common in Crohn’s disease than ulcerative colitis.

The list of eye conditions associated with IBS includes:

  • Conjunctivitis, or pink eye, caused by inflammation of the conjunctiva rather than infection.
  • Episcleritis and scleritis, which is inflammation of the blood vessels between the sclera and conjunctiva, which causes part of the eye to appear red. If the inflammation of scleritis becomes severe enough, vision can be damaged.
  • Marginal keratitis, or inflammation of the cornea specifically, which can cause blurry vision.
  • Anterior uveitis, which is a general term for inflammation of the interior structures of the eye, which can also lead to vision loss if it is severe.
  • Keratopathy, a corneal disease causing the sensation of having something in your eye, eye pain, and, rarely, decreased vision.
  • Retinitis, or inflammation of the retina, the light-sensing organ at the back of the eye. If left untreated, this condition can cause blindness.
  • Retinal vascular occlusive disease, which is a blockage of the veins in the retina that causes damage, leading to blindness.
  • Optic neuritis, or inflammation of the optic nerve, which may cause temporary vision loss in one eye at a time. This typically goes away on its own.
  • Orbital inflammatory disease, which involves inflammation of the tissues around the eye.

These conditions could develop before or after the diagnosis of IBS, but they tended to be associated with the onset of other symptoms.

Corticosteroids are the first choice for reducing inflammation associated with many autoimmune conditions, including IBS. These can help reduce swelling associated with parts of the eye too.

Dry Eyes & IBSitchy eyes

Dry eye disease is one of the more common symptoms associated with IBS, potentially because both conditions involve inflammation. One medical study examined 95 people with IBS, alongside 276 healthy people in a control group. Two studies that looked at tear production and quality found that people with IBS produced fewer tears, and they were not high-quality tears.

Chronic dry eye disease is a complex condition that involves both the tear glands and the surface of the eye. New medical evidence suggests that autoimmune conditions can attack the tear glands and various parts of the eye, leading to inflammation, poor tear production, and low tear quality. Since IBS is also an immune system disorder, chronic dry eye may develop as a secondary condition because of this underlying condition.

LASIK & Inflammatory Bowel Syndrome

Many people with refractive errors pursue LASIK so they will no longer need glasses or contact lenses, but people with IBS and other autoimmune conditions typically do not respond well to cosmetic eye surgery. Tissue inflammation can get worse, especially in the eye, and the risk of developing serious, chronic dry eye is high.

People who undergo LASIK often develop dry eyes for six months after the procedure, but anyone who already has dry eye or is at a higher risk of developing this condition may develop this as a serious issue. It can cause some tissue damage.

IBS Treatment, Cataracts & Cataract Surgery

If you take corticosteroids to manage IBS symptoms, including eye inflammation, you have an increased risk for developing cataracts later. Ask your doctor about concerns regarding steroid medications and cataracts, especially if you have a family history of developing this condition.

Be sure to get regular eye exams — not just to diagnose any potential inflammatory eye conditions but also because your optometrist can diagnose cataracts before the condition changes your vision or causes blind spots.

Cataracts take years to obscure your vision to the point that you will need surgery. Cataract surgery is a well-understood, common procedure. Most people who need to have their natural lens replaced with an artificial one get good vision and have good health outcomes overall.

References

What Is Inflammatory Bowel Disease (IBD)? (March 2018). Centers for Disease Control and Prevention (CDC).

Inflammatory Bowel Disease. (April 2020). National Health Service (NHS).

Irritable Bowel Syndrome (IBS): Introduction. Johns Hopkins Medicine.

Ocular Complications of Inflammatory Bowel Disease. (March 2015). The Scientific World Journal.

Irritable Bowel Syndrome Might Be Associated With Dry Eye Disease. (December 2016). Annals of Gastroenterology.

Refractive Eye Surgery: Helping Patients Make Informed Decisions About LASIK. (May 2017). American Family Physician.

What Causes Steroid Cataracts? A Review of Steroid-Induced Posterior Subcapsular Cataracts. (March 2002). Clinical and Experimental Optometry.