Systemic diseases and the cornea

Exp Eye Res. 2021 Mar:204:108455. doi: 10.1016/j.exer.2021.108455. Epub 2021 Jan 21.


There is a number of systemic diseases affecting the cornea. These include endocrine disorders (diabetes, Graves' disease, Addison's disease, hyperparathyroidism), infections with viruses (SARS-CoV-2, herpes simplex, varicella zoster, HTLV-1, Epstein-Barr virus) and bacteria (tuberculosis, syphilis and Pseudomonas aeruginosa), autoimmune and inflammatory diseases (rheumatoid arthritis, Sjögren's syndrome, lupus erythematosus, gout, atopic and vernal keratoconjunctivitis, multiple sclerosis, granulomatosis with polyangiitis, sarcoidosis, Cogan's syndrome, immunobullous diseases), corneal deposit disorders (Wilson's disease, cystinosis, Fabry disease, Meretoja's syndrome, mucopolysaccharidosis, hyperlipoproteinemia), and genetic disorders (aniridia, Ehlers-Danlos syndromes, Marfan syndrome). Corneal manifestations often provide an insight to underlying systemic diseases and can act as the first indicator of an undiagnosed systemic condition. Routine eye exams can bring attention to potentially life-threatening illnesses. In this review, we provide a fairly detailed overview of the pathologic changes in the cornea described in various systemic diseases and also discuss underlying molecular mechanisms, as well as current and emerging treatments.

Keywords: Addison's disease; Aniridia; Autoimmune disease; Corneal deposit disorder; Diabetic cornea; Ehlers-Danlos syndrome; Genetic corneal disease; Graves' disease; Herpes; Immunobullous disease; Inflammation; Keratoconjunctivitis; Marfan syndrome; Pseudomonas aeruginosa; SARS-CoV-2; Sjögren's syndrome; Syphilis; Tuberculosis; Zoster.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / epidemiology*
  • COVID-19 / epidemiology*
  • Comorbidity
  • Cornea / pathology*
  • Humans
  • SARS-CoV-2