Ulcerative Colitis and Your Eyes

Medically Reviewed by Whitney Seltman, OD on May 26, 2022
4 min read

When you’re living with ulcerative colitis (UC), it can affect parts of your body beyond your colon. That includes your eyes.

UC is a type of inflammatory bowel disease (IBD). And about 10% of people with IBD get eye problems.

If your eyes have been getting irritated or inflamed, make an appointment with an eye doctor called an ophthalmologist as soon as possible. They can diagnose and treat eye conditions. They can also work together with your ulcerative colitis doctor, so you get the best care possible.

Here are some eye conditions that are tied to IBD and UC.

This is the most common eye-related complication of IBD. It’s when the outer coating of the white of your eyes gets inflamed.

It can bring on redness, pain, and tenderness.

Episcleritis is linked to how IBD affects your body. That means the more severe the inflammation in your gut, the more severe a case of episcleritis you have, says board-certified gastroenterologist Tauseef Ali, MD. He’s the medical executive director of SSM Health Digestive Institute and director of SSM Health Crohn’s and Colitis Center in Oklahoma City, OK.

Most of the time, treating the inflammation of UC causes this eye problem to get better, too, Ali says.

An eye doctor can also treat episcleritis with eye drops and topical drugs called vasoconstrictors.

This condition affects the white part of your eye, or sclera. It’s another complication of IBD, Ali says.

Scleritis can bring on symptoms like:

  • Pain or tenderness
  • Redness and swelling in the white part of your eye
  • Blurry sight
  • Tearing
  • Being extremely sensitive to light
  • Pain in your jaw, face, or head

If you don’t get treatment as soon as possible, you could lose some or all of your vision. Some treatments for scleritis are:

  • Steroid pills or eye drops
  • NSAID drugs like aspirin or ibuprofen
  • Eye solutions or antibiotics
  • Drugs that lower your immune system
  • Surgery (for severe cases)

Scleritis isn’t linked to how bad your IBD is. That means it’s possible to have mild UC with severe scleritis, or severe UC with mild scleritis.

This is one of the most serious eye problems linked to IBD. It’s when the middle layer of your eye wall, the uvea, gets inflamed.

You may have symptoms that come on gradually or suddenly, like:

See your eye doctor right away if you notice these symptoms. If you have uveitis, it can permanently damage your eye and cause vision loss without treatment, Ali says.

Your doctor may prescribe steroid eye drops that lower inflammation or dilation drops that help ease pain and swelling. Some people need to take pills or get shots.

If you have uveitis, its severity isn’t related to how bad your IBD is. That means if your UC is mild, you could still get uveitis that’s severe, and vice versa.

This is a problem with the clear, outer layer of your eye, the cornea. It’s a rare complication linked to IBD.

Keratopathy can bring on dry eye, Ali says. Most of the time, your primary care doctor can treat it with lubricants and artificial tears.

Yes. Some eye complications can be caused by drugs you’re taking for UC.

If your UC doctor or your eye doctor thinks this is happening, they can work together to fine-tune your treatment if needed, Ali says. For instance, they might decide to change the dose of your drug or switch you to a different one.

Some eye problems linked to UC drugs are:

Cataracts and glaucoma. Steroids can cause either of these common conditions, Ali says.

A cataract makes your eye’s natural lens cloudy. It can make things look blurry, hazy, or less colorful. If it bothers you a lot, you can get it removed with surgery.

Glaucoma is a disease that, without treatment, can damage your optic nerve, which allows you to see. There are different types of it, but any of them could bring on symptoms like eye pain or pressure, headaches, and worse vision, including blind spots. Some treatments that can slow the permanent vision loss it causes are medication, laser procedures, and surgery.

Retinopathies. These are diseases that damage the part of your eye that senses light (the retina). They’re rarely linked to IBD. But they can happen due to certain biologic drugs that treat IBD, Ali says.

If you’re diagnosed with retinopathy, your eye doctor has treatments that can lower your chances for losing your sight.

Make an appointment as soon as possible if you notice eye problems. The Crohn’s and Colitis Foundation also recommends you get a regular exam from an optometrist or ophthalmologist.

Lots of common eye diseases don’t cause symptoms early on. So, getting a checkup can help you nip problems in the bud, including eye complications linked to UC.

If you don’t have an eye doctor, ask your friends, family members, or your other doctors if they can recommend one. You can also search for one in your area through the American Academy of Ophthalmology. If you have health insurance, you can look for eye doctors near you on your health plan’s website, too.

Some eye complications linked to UC can lead to permanent vision loss. So, the sooner you get these issues diagnosed and treated, the better for your health.