Ocular, aural, and oral manifestations of lupus

Lupus can affect almost any organ in the body; similarly, it can attack many different tissues within the eye; and it has frequent manifestations in the mouth, nose, or ear. Dryness is the most common ocular manifestation of lupus. Cotton wool spots in the retina are indicative of local ischemia and can have therapeutic implications. The eye has a variety of vascular beds including retina, choroid, sclera, episclera, and conjunctiva. Lupus can affect any of these circulations. Less common ophthalmic manifestations include optic neuritis, scleritis, uveitis, peripheral ulcerative keratitis, orbital inflammation, eyelid lesions, and central nervous system disease that affects vision or ocular motility. And all rheumatologists should be familiar with retinal toxicity from antimalarial therapy. Oral ulcers are generally included as a classification criterion for lupus. Sensorineural hearing loss is surprisingly common among patients with lupus. Awareness of these signs of lupus often has diagnostic and therapeutic implications that might require a multidisciplinary approach to the disease.