**2.4. Systemic lupus erythematosus (SLE)**

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease with diverse symptomatology resulting from involvement of many organs and systems. The prev‐ alence of SLE in the general population ranges from 0.016 to 0.092% [33,34,35]. The typical clinical features of SLE include facial erythema, discoid rash, photosensitivity, oral ulcers, arthritis, pleurisy or pericarditis, kidney changes, changes in the central nervous system, haematological disorders (such as hemolytic anemia, leukopenia, lymphopenia, thrombocy‐ topenia), immune changes with presence of antinuclear, anti-DNA and anti-Sm autoantibod‐ ies, as well as false positive syphilis tests. SLE may be associated with antyphospolipid syndrome (APS) with thrombotic episodes in the arteries and veins and obstetrics failure in women. Diagnosis is based on the revised 1997 ACR classification criteria [36]. Changes in the organ of sight occur in approximately 25% of patients, mainly in the course of secondary Sjögren's syndrome but also as result of vasculitis and thrombosis [37]. Conjunctivitis, episcleritis and interstitial keratitis are rare [38].

#### **2.5. Primary Sjögren's syndrome**

Primary Sjögren's syndrome (pSS) is an inflammatory autoimmune disease that occurs most often in women between 40 and 50 years of age. The clinical symptoms of the disease result from B cell autoreactivity, polyclonal immunoglobulin overproduction and infiltration of exocrine glands by lymphocytes (CD4 cells predominate). The dominant symptom is dry‐ ness of the mouth and eyes. The nonerosive arthritis, vasculitis, peripheral neuropathy and different symptoms from central nervous system are also observed in pSS. According to dif‐ ferent data Sjögren's syndrome prevalence rate ranges from 0.2 to 13.3% of the population [39,40,41]. Sjögren's syndrome is diagnosed on the basis of the revised 2002 American-Euro‐ pean criteria[42]. Ocular symptoms associated with impaired secretion of tears occur in all patients with Sjögren's syndrome – either in the initial or more advanced stages of the dis‐ ease – and constitute one of to the diagnostic criteria. Treatment is based on the use of both symptomatic drugs - moistening eyes and mouth – and of immunosuppressants.

### **2.6. Scleroderma**

**2.3. Juvenile idiopathic arthritis**

**2.4. Systemic lupus erythematosus (SLE)**

interstitial keratitis are rare [38].

**2.5. Primary Sjögren's syndrome**

logical agents.

218 Common Eye Infections

Juvenile idiopathic arthritis is the most common form of chronic inflammation of the con‐ nective tissue in children. Prevalence in the population is 43-148 cases per 100 000 persons [29,30,31]. The diagnosis of JIA is based on the 1997 ILAR criteria. For the arthritis do be di‐ agnosed as JIA the onset of the disease must take place until 16 years of age, arthritis symp‐ toms must last more than 6 weeks and other diseases in which arthritis occurs have to be excluded ( e.g.infectious, reactive, toxic and allergic and neoplastamatic diseases and other conditions with joint involvment). Ocular complications - mainly uveitis - occur in approxi‐ mately 12-17% of juvenile patients [32]. Treatment, as in RA, is based on DMARDs and bio‐

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease with diverse symptomatology resulting from involvement of many organs and systems. The prev‐ alence of SLE in the general population ranges from 0.016 to 0.092% [33,34,35]. The typical clinical features of SLE include facial erythema, discoid rash, photosensitivity, oral ulcers, arthritis, pleurisy or pericarditis, kidney changes, changes in the central nervous system, haematological disorders (such as hemolytic anemia, leukopenia, lymphopenia, thrombocy‐ topenia), immune changes with presence of antinuclear, anti-DNA and anti-Sm autoantibod‐ ies, as well as false positive syphilis tests. SLE may be associated with antyphospolipid syndrome (APS) with thrombotic episodes in the arteries and veins and obstetrics failure in women. Diagnosis is based on the revised 1997 ACR classification criteria [36]. Changes in the organ of sight occur in approximately 25% of patients, mainly in the course of secondary Sjögren's syndrome but also as result of vasculitis and thrombosis [37]. Conjunctivitis, episcleritis and

Primary Sjögren's syndrome (pSS) is an inflammatory autoimmune disease that occurs most often in women between 40 and 50 years of age. The clinical symptoms of the disease result from B cell autoreactivity, polyclonal immunoglobulin overproduction and infiltration of exocrine glands by lymphocytes (CD4 cells predominate). The dominant symptom is dry‐ ness of the mouth and eyes. The nonerosive arthritis, vasculitis, peripheral neuropathy and different symptoms from central nervous system are also observed in pSS. According to dif‐ ferent data Sjögren's syndrome prevalence rate ranges from 0.2 to 13.3% of the population [39,40,41]. Sjögren's syndrome is diagnosed on the basis of the revised 2002 American-Euro‐ pean criteria[42]. Ocular symptoms associated with impaired secretion of tears occur in all patients with Sjögren's syndrome – either in the initial or more advanced stages of the dis‐

Scleroderma is an inflammatory connective tissue disease of unknown etiology character‐ ized by the damage to blood vessels, the presence of autoantibodies (SCL 70 or anticen‐ tromeric autoantibodies for diffuse systemic sclerosis and localised systemic sclerosis respectively) and progressive fibrosis of the skin and internal organs. Systemic sclerosis prevalence rate in the world is ranging from 0.0007% to 0.265% [43,44,45]. Disease diag‐ nosis based on the classification and diagnostic criteria of the 1980 ACR [46]. 71% of patients present changes in blood and conjunctival subepithelial fibrosis. In course of SS all structures of the eye may be affected [47,48]. Patient with SS may develop secon‐ dary Sjogren's syndrome and symptoms of dry eye, as well as complications due to the dryness of the conjunctiva [49].

#### **2.7. Recurrent inflammation of the cartilage**

Recurrent inflammation of the cartilage is a rare inflammatory autoimmune disease in which the inflammatory process involving mostly cartilage, causing changes and dysfunc‐ tion of many tissues and organs. Onset of the disease usually affects people of 40-60 years of age and the prevalence of this disease in the world is estimated at about 3 cases per 1 million people in the population [50]. Currently, the diagnosis of this disease can be based on the diagnostic criteria of McAdam, 1976 [51]. Changes in the organ of vision occur in approxi‐ mately 60% of patients and may include almost all structures of the eye [52, 53].
