Mumbai: a 60 year old man welfare The resident’s routine cataract surgery turned into a race to save his eyesight after doctors revealed he had an unusual form of an autoimmune disease called rheumatoid arthritis (RA).RA is a condition in which the immune system mistakenly attacks the lining of the joints. But in the case of Subhash Pardikar, a former Kalyan Municipal Corporation employee, there were no joint-related symptoms.Pardikar underwent cataract surgery in both eyes at a local eye hospital in February. One eye healed normally, while the other continued to have redness, pain, and swelling. After treatment with antibiotics for a month, his ophthalmologist referred him to a senior doctor in Dadar. “The doctor in Dadar took a look at my right eye and asked me to consult a rheumatologist,” Pardikar said.Tests revealed that Pardikar’s RA markers were highly positive. Dr Snehal Patil, a rheumatologist at Fortis Hospital in Kalyan, who treated him, said, “His rheumatoid factor was elevated and RA-related antibody (anti-CCP) was more than 500. Yet he had none of the classic RA symptoms like swollen joints, prolonged morning stiffness or limited movement.”Pardikar said that four-five years ago he suffered from intermittent joint pain. “But the symptoms disappeared after a few months of Ayurvedic treatment,” he said.Dr. Patil diagnosed him with RA-associated autoimmune peripheral ulcerative keratitis, a rare but potentially blinding inflammatory eye condition. “Autoimmune diseases don’t always exist in textbook form. In some patients, rheumatological conditions can affect organs such as the eyes before other symptoms appear,” the doctor said.Dr. Sumeet Lahane of Raghunath Nethralaya and MGM College, Navi Mumbai said autoimmune peripheral ulcerative keratitis remains a rare but serious condition. “It is associated with thinning of the cornea and loss of vision. In the early stages, it can be difficult to diagnose,” he said.Dr. Lahane, who sees five to six such patients annually, said that once the diagnosis is made, treatment is easy. “In advanced cases, a patient may require a corneal graft,” he said.Pardikar also had a severely melted cornea, with his eye doctors using “tissue glue” to save his cornea. Dr. Patil started him on intravenous steroids, followed by oral steroids and an immunosuppressant drug called cyclophosphamide. Over the next few weeks, the swelling went down, the corneal damage stabilized and healing gradually began.