Extraintestinal Manifestations of IBD: An “Eye” on Episcleritis

As many of you know, I was recently in Austin, TX, traveling to speak at Crohn’s & Colitis Congress. So, when I landed in Austin, I noticed a tinge of red in my right eye and I was a bit concerned but thought it would go away. You see, the dryness of the flight does sometimes irritate my eyes. But as I spent more and more time in Austin, I realized my eyes were reacting to something in the air with construction dust constantly assaulting my eyes. At this point, I became really alarmed because I knew this could be the beginnings of episcleritis, a form of eye inflammation that is connected to autoimmune conditions.[1]

The redness continued to worsen in my right eye only but come the last morning of the conference, the inflammation had spread to my left eye like spider veins. After my IBD Insider panel, one of the doctors so kindly asked if I was okay and to make sure I get my eyes checked out. That afternoon I called my ophthalmologist’s emergency line and when she went to prescribe drops, there were no pharmacies in town that were open Saturday evening. I had to wait until noon on Sunday to have the steroid and antibiotic drops filled. Nevertheless, the drops didn’t really work and my eyes continued to worsen.

The morning after I landed in New York, I rushed to her office and she told me this was the worst episode of episcleritis she had seen on me, that there were multiple things going: dry eyes, eyes allergic to the dust that was coming at me in Austin and Crohn’s.

Yes, Crohn’s. So what does Crohn’s have to do with it? Inflammatory bowel disease can come with multiple types of extraintestinal manifestations, including eye inflammation, particularly uveitis and episcleritis, and they can be very painful with all the stinging, burning and at times, blurry vision. The redness can be quite alarming and can be connected to multiple autoimmune conditions. The inflammation may come as a precursor to diseases such as IBD or it can happen at unrelated times. Nevertheless, it is important to be examined and treated for recurrent episodes according to my physician. 

Even though the Prednisone eye drops worked to quell the inflammation quickly, the episode has left a bit of trauma behind. The fact is I’m used to living with so many invisible illnesses but what I couldn’t wrap my head around was how visible the episcleritis was. It is both a blessing and a curse to live with invisible illnesses. On the one hand, the world hasn’t the slightest clue as to how sick I am and on the other, having extremely bloodshot eyes or needing accommodations everywhere I go makes my disabilities very obvious. This is but the conundrum many of us with chronic illnesses deal with: disclosure is frowned upon as is needing assistance. So where does that balance lie? It’s a question I’ve been trying to figure out for ages.

In the meantime, I’m working on keeping the episcleritis under control as I will be tapering for the next month to ensure the eye symptoms don’t recur anytime soon. So, own your Crohn’s, own your autoimmune condition(s), and recognize when symptoms are on the brink of appearing so you can advocate for the most efficient and effective care possible.

[1] https://www.mountsinai.org/health-library/diseases-conditions/episcleritis

~~Love, Light & Peace Always~~

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