Study Finds Eye Disorders to be Rare but Significant in Inflammatory Bowel Disease
A recent study published in the journal of the Inflammatory Bowel Diseases revealed the underexplored link between inflammatory bowel disease (IBD) and eye complications, known as ocular manifestations (OMs). This research found that while such eye disorders are relatively uncommon, they represent a clinically important concern among patients with Crohn’s disease and those with more severe disease activity.
The study from 2005 to 2024 analyzed data from 15,035 adults newly diagnosed with IBD. Of these, 51.8% had Crohn’s disease (CD) and 48.2% had ulcerative colitis (UC). The patients who already had eye inflammation before their IBD diagnosis were excluded to ensure accurate measurement of new cases.
Ocular manifestations assessed in the study included uveitis (inflammation of the middle layer of the eye), episcleritis and scleritis (inflammations of the outer eye tissues), and orbital inflammation. Across a total follow-up of nearly 120,000 person-years, 349 patients developed one of these conditions, which translated to an incidence rate of 2.9 cases per 1,000 person-years (95% confidence interval: 2.62–3.24).
Crohn’s disease patients showed a significantly higher rate of ocular complications when compared to those with ulcerative colitis (log-rank P < .001). The incidence of OMs, however, did not show a statistically significant change over the 20-year observation period (P = .125), suggesting that while diagnostic and treatment practices for IBD have evolved, the risk of eye complications has remained stable.
The median time from IBD diagnosis to onset of an ocular manifestation was 45 months, which highlights the need for long-term vigilance. In analyzing risk factors, this research found distinct patterns between the 2 forms of IBD. Among Crohn’s disease patients, female sex and systemic corticosteroid use were associated with a higher risk of developing eye complications, each increasing risk by approximately 60% (hazard ratio [HR] 1.62). For ulcerative colitis patients, corticosteroid use was also a significant risk factor (HR 2.17), and those who underwent intestinal surgery had more than a threefold increased risk (HR 3.50).
These findings illuminate the importance of routine eye evaluations and interdisciplinary care for IBD patients, especially the patients who require systemic steroid therapy or surgery, both markers of more severe disease. Overall, while eye inflammation remains an uncommon extraintestinal manifestation of IBD, it serves as a valuable indicator of disease severity and the need for comprehensive, coordinated care.
Source:
Yanai, H., Achler, T., Ben-Tov, A., Sharar Fischler, T., Patalon, T., Gazit, S., Assa, A., & Shulman, S. (2025). Incidence of ocular manifestation after adult-onset inflammatory bowel disease: A 20-year population-based cohort study. Inflammatory Bowel Diseases, izaf213. https://doi.org/10.1093/ibd/izaf213
