Irritable Bowel Syndrome, Inflammatory Bowel Disease & Eye Issues
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Irritable bowel syndrome (IBS) is an intestinal disorder that causes constipation, diarrhea, gas, and stomach pain. While it is theorized that IBS could be linked to dry eye, this hasn’t been definitively found.
Inflammatory bowel disease (IBD) is linked to various eye issues, including chronic dry eye, ocular pain, photophobia, loss of visual acuity, and eye pain. This is because inflammation associated with IBD can also affect tissues in the eyes, leading to vision problems.
Because of tissue inflammation, poor healing, and the higher risk of dry eye, LASIK is not recommended for people with inflammatory bowel disease.
Treatment for IBD is often corticosteroids, which can increase the risk of cataracts.
How Does Irritable Bowel Syndrome Affect the Eyes?
Irritable bowel syndrome is not directly linked to eye issues, but some experts theorize that there might be a link.
A relatively small study hypothesized that IBS may be connected to dry eye disease. In the study, 95 people with IBS were assessed, alongside 276 healthy people in a control group.
They looked at tear production and quality found that people with IBS produced fewer tears, and they were not high-quality tears. But the study concluded that further research is needed to further explore this potential association.
When people discuss eye issues related to gastrointestinal issues, they are usually talking about inflammatory bowel disease rather than irritable bowel syndrome.
How Does Inflammatory Bowel Disease Affect the Eyes?
Inflammatory bowel disease 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, IBD 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 IBD:
- Persistent diarrhea
- Abdominal pain
- Weight loss
The cause of IBD is not known, but both conditions associated with IBD seem to involve the immune system attacking the gastrointestinal tract, which causes inflammation.
There are several treatments for IBD, one of which is corticosteroids like prednisone. Again, these treatments can have negative effects on the eyes.
Eye Problems Associated With IBD
Since IBD 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 inflammatory bowel disease and seemed to be more common in Crohn’s disease than ulcerative colitis.
Eye conditions associated with IBD include the following:
- Conjunctivitis: Also called pink eye, this is caused by inflammation of the conjunctiva rather than infection.
- Episcleritis and scleritis: This 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: This is inflammation of the cornea specifically, which can cause blurry vision.
- Anterior uveitis: This 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: This is a corneal disease that causes the sensation of having something in your eye, eye pain, and, rarely, decreased vision.
- Retinitis: This is 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: This is a blockage of the veins in the retina that causes damage, leading to blindness.
- Optic neuritis: This is 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: This involves inflammation of the tissues around the eye.
These conditions could develop before or after the diagnosis of IBD, but they tend to be associated with the onset of other symptoms.
Corticosteroids are the first choice for reducing inflammation associated with many autoimmune conditions, including IBD. These can help reduce swelling associated with parts of the eye too.
Dry Eyes & IBD
Dry eye disease is one of the more common symptoms associated with inflammatory bowel disease, potentially because both conditions involve inflammation.
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 IBD is also an immune system disorder, chronic dry eye may develop as a secondary condition because of the underlying primary disorder.
LASIK & Inflammatory Bowel Disease
Many people with refractive errors pursue LASIK so they will no longer need glasses or contact lenses, but people with IBD and other autoimmune conditions typically do not respond well to this kind of 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.
IBD Treatment, Cataracts & Cataract Surgery
If you take corticosteroids to manage IBD 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.
Maintaining Good Eye Health
If you have irritable bowel disease, it’s important to get regular checkups with an ophthalmologist to detect and manage any potential eye issues. Since you are more at risk for certain issues due to inflammation, early detection is crucial.
If you have irritable bowel syndrome, it’s unlikely that you have eye issues related to your IBS, but it’s still a good idea to see an eye doctor regularly. Even if any eye issues you may have are not directly caused by IBS, your eye doctor will still be able to assess, diagnose, and manage any problems you do experience.
- Irritable Bowel Syndrome Might Be Associated With Dry Eye Disease. (October–December 2016). Annals of Gastroenterology.
- What Is Inflammatory Bowel Disease (IBD)? (March 2018). Centers for Disease Control and Prevention.
- Inflammatory Bowel Disease. (April 2020). National Health Service.
- Irritable Bowel Syndrome (IBS): Introduction. Johns Hopkins Medicine.
- Ocular Complications of Inflammatory Bowel Disease. (March 2015). The Scientific World Journal.
- 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.