**3. Characteristic changes in the organ of sight in rheumatic diseases**

The pathological changes can occur in all elements of the organ of sight in the course of rheumatic diseases. These can cause temporary or permanent damage (Table 5). Changes in the eyes are the first symptom of rheumatic fever observed in approximately 4% of patients [65].


**Table 5.** The most common ocular changes in the course of the rheumatic diseases.

Changes in the eyes in course of the rheumatic diseases may also be caused by the imple‐ mented treatment. Nonsteroidal anti-inflammatory drugs are medications most commonly used in alleviating the symptoms of rheumatic diseases. Cases of keratopathy (keratopathy) after indomethacin use have been reported [66], and diplopia (double vision) and amblyopia (amblyopia) after ibuprofen and naproxen treatment [67]. Antimalaric drugs such as hy‐ droxychloroquine and more often chloroquine may aggregate in the cornea [68], in 13 - 40% of patients causing retinopathy [69,70]. Gold salts - administered parenterally over the total dose of 1000mg/kg of body weight – accumulate in various tissues of the body and have been observed in the eyes (conjunctiva, cornea, anterior lens and retina) in 97% of patients [71]. Gold salt deposits in the eyes may cause hypersensitivity reactions, induce inflamma‐ tion and cause marginal ulceration [72]. After methotrexate therapy diffuse irritation of the cornea is observed [73]. Chronic glucocortycoid therapy often leads to cataracts, subcapsular cataracts and glaucoma [74, 75].
