Lupus-Induced Myopic Shift

Abstract

While ophthalmic manifestations of lupus are common, a myopic shift is a rare manifestation of systemic lupus erythematosus (SLE). An acute myopic shift is defined as a progressive worsening of nearsighted vision within a short time frame. Here, we describe the unique presentation of a young woman with a lupusinduced acute myopic shift. The patient presented with blurry vision and bleeding gums with a previous abnormal lymph node biopsy to rule out ocular lymphoma or leukemia. Her baseline prescription prior to coming in was −4.0D in both eyes. Upon exam, she presented with vision worsening: −7.0D in the right eye and −8.2D in the left eye. After completing blood laboratory tests, it became clear that she had pancytopenia, kidney damage, and elevated inflammatory markers pointing towards lupus. A diagnosis of acute binocular myopic shift induced by systemic lupus erythematosus was made.

Unveiling Ocular Manifestations in Systemic Lupus Erythematosus

“…A relative shift of the habitual refractive status in SLE which is termed "acute onset myopia" has been reported, and it is mostly characterized by an increment of the net dioptric power of the eye. The myopic shift in SLE is proposed to result mostly from ciliary spasm secondary to the ciliary body inflammatory response to autoimmune antibodies and freely circulating cytokines [111,112].…”