Dry eye disease (DED) represents one of the most prevalent ocular manifestations associated with systemic lupus erythematosus (SLE), with reported incidence rates ranging from 15% to 35%. DED constitutes a multifactorial condition that significantly impairs both visual function and health-related quality of life. The objective of this study was to assess the impact of DED symptoms on vision-related quality of life in patients diagnosed with SLE, employing the Ocular Surface Disease Index (OSDI) as a disease-specific instrument. Additionally, the study aimed to evaluate correlations between clinical diagnostic tests and OSDI scores, and to determine the frequency of abnormalities affecting individual ocular structures. This study included 35 SLE patients, identifying DED in 37.1%. Common ophthalmic abnormalities included lens opacification (22.9%) and hyaloid degeneration (34.3%). Astigmatism (>0.50 D cyl) was prevalent (60.0%), being significantly higher in DED patients. While visual acuity and intraocular pressure were comparable, DED patients showed significantly lower Schirmer I test values, reduced tear break-up time, and higher van Bijsterveld scores, indicating impaired tear film and surface integrity. OSDI scores were significantly elevated in the DED group, with 51.4% reporting moderate to severe dysfunction. Strong, statistically significant correlations between the OSDI and objective tear film parameters confirmed a robust association between subjective symptoms and clinical signs. These findings highlight the significant impact of DED on visual function in SLE patients, underscoring the importance of routine ophthalmological evaluation and timely intervention.

Dry eye disease (DED) represents one of the most prevalent ocular manifestations associated with systemic lupus erythematosus (SLE), with reported incidence rates ranging from 15% to 35%. DED constitutes a multifactorial condition that significantly impairs both visual function and health-related quality of life. The objective of this study was to assess the impact of DED symptoms on vision-related quality of life in patients diagnosed with SLE, employing the Ocular Surface Disease Index (OSDI) as a disease-specific instrument. Additionally, the study aimed to evaluate correlations between clinical diagnostic tests and OSDI scores, and to determine the frequency of abnormalities affecting individual ocular structures. This study included 35 SLE patients, identifying DED in 37.1%. Common ophthalmic abnormalities included lens opacification (22.9%) and hyaloid degeneration (34.3%). Astigmatism (>0.50 D cyl) was prevalent (60.0%), being significantly higher in DED patients. While visual acuity and intraocular pressure were comparable, DED patients showed significantly lower Schirmer I test values, reduced tear break-up time, and higher van Bijsterveld scores, indicating impaired tear film and surface integrity. OSDI scores were significantly elevated in the DED group, with 51.4% reporting moderate to severe dysfunction. Strong, statistically significant correlations between OSDI and objective tear film parameters confirmed a robust association between subjective symptoms and clinical signs. These findings highlight the significant impact of DED on visual function in SLE patients, underscoring the importance of routine ophthalmological evaluation and timely intervention.

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder in which ocular involvement represents a clinically significant yet frequently underrec-ognized contributor to morbidity. Ocular manifestations in SLE may arise from disease activity itself, but also as adverse effects of long-term pharmacological therapy. With the advent of targeted immunomodulatory agents, the therapeutic landscape of SLE has expanded beyond conventional drugs such as hydroxychloroquine and corticosteroids toward biologics and small molecules designed to interfere with specific immunological pathways. These advances have improved systemic disease control and survival; however, their ophthalmological safety profiles remain only partially defined. This review synthesizes current evidence on ocular adverse events associated with both traditional and emerging SLE therapies. Established agents, particularly hydroxychlo-roquine and corticosteroids, are consistently linked to complications including reti-nopathy, posterior subcapsular cataracts, steroid-induced glaucoma, and central serous chorioretinopathy. In contrast, recently approved or investigational therapies—such as belimumab, anifrolumab, voclosporin, dual BAFF/APRIL inhibitors, rituximab, JAK in-hibitors, CD40/CD40L blockade, CD38 inhibition, and mesenchymal stromal cell–based strategies—have limited but evolving safety data, with potential ocular adverse events spanning inflammatory, vascular, neuro-ophthalmic, and structural domains. Although ocular complications appear infrequent in clinical trials, underdetection in real-world practice and insufficient long-term monitoring may underestimate their true incidence. These findings highlight the need for systematic ophthalmological surveil-lance in patients receiving immunomodulatory therapies for SLE. Early recognition and timely management of ocular toxicity are crucial to safeguarding visual function and optimizing long-term therapeutic outcomes in this vulnerable patient population.

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder in which ocular involvement represents a clinically significant yet frequently underrecognized contributor to morbidity. Ocular manifestations in SLE may arise from disease activity itself, but also as adverse effects of long-term pharmacological therapy. With the advent of targeted immunomodulatory agents, the therapeutic landscape of SLE has expanded beyond conventional drugs such as hydroxychloroquine and corticosteroids toward biologics and small molecules designed to interfere with specific immunological pathways. These advances have improved systemic disease control and survival; however, their ophthalmological safety profiles remain only partially defined. This review synthesizes current evidence on ocular adverse events associated with both traditional and emerging SLE therapies. Established agents, particularly hydroxychloroquine and corticosteroids, are consistently linked to complications including retinopathy, posterior subcapsular cataracts, steroid-induced glaucoma, and central serous chorioretinopathy. In contrast, recently approved or investigational therapies—such as belimumab, anifrolumab, voclosporin, dual BAFF/APRIL inhibitors, rituximab, JAK inhibitors, CD40/CD40L blockade, CD38 inhibition, and mesenchymal stromal cell-based strategies—have limited but evolving safety data, with potential ocular adverse events spanning inflammatory, vascular, neuro-ophthalmic, and structural domains. Although ocular complications appear infrequent in clinical trials, underdetection in real-world practice and insufficient long-term monitoring may underestimate their true incidence. These findings highlight the need for systematic ophthalmological surveillance in patients receiving immunomodulatory therapies for SLE. Early recognition and timely management of ocular toxicity are crucial to safeguarding visual function and optimizing long-term therapeutic outcomes in this vulnerable patient population.