Updated on 04/06/18.
What are the symptoms of Sweet’s syndrome?
The main symptoms of Sweet’s syndrome are fever and skin lesions that often appear as a sore or painful red or purple rash, but you may experience other symptoms. Read more here.
Can Sweet’s syndrome affect the eyes?
Yes, Sweet’s syndrome can affect the eyes in up to 72% of patients (Bilgin et al, 2015:54). Usually, only one eye will be affected, but it is possible for both eyes to be affected at the same time (Zaouak et al, 2017; Zhuang and Li, 2011).
What are the symptoms?
Initial symptoms often include:
- Eyes feeling sore.
- Eye pain, e.g sharp or stabbing pain.
- Blurry vision.
- Eye redness.
- Dry eyes. Some eye problems caused by Sweet’s syndrome may also increase the risk of developing ‘dry eye syndrome’. However, this can happen for lots of different reasons that may not be related to Sweet’s syndrome. See ‘Further information’ to learn more.
- Eye watering.
- ‘Sticky’ eyes.
- Sensitivity to light.
On rare occasions, eye symptoms may worsen causing severe inflammation, tissue damage, ulceration, and vision loss. In December 2017, the first case of permanent vision loss in the left eye was reported in a 40-year-old man with Sweet’s syndrome and probable myelodysplastic syndrome or myeloproliferative neoplasm (Jang et al, 2017).
Can Sweet’s syndrome affect the eyes even if skin lesions are not present?
Yes, it is possible to have Sweet’s syndrome-related eye problems even when skin lesions are not present, but this is not common (Bilgin et al, 2015:54; Koay et al, 2013).
What are the commonest eye problems?
Conjunctivitis, episcleritis, limbal nodules and iridocyclitis are the some of the commonest eye problems (Baartman et al, 2014:193).
What other eye problems can Sweet’s syndrome cause?
Other eye problems include:
- Blepharitis (Cohen, 2007).
- Choroiditis (Baartman et al, 2014:193).
- Conjunctival erythematous lesions with tissue biopsy showing neutrophilic inflammation (Cohen, 2007).
- Conjunctival haemorrhage.
- Conjunctival nodules (Zhuang and Li, 2011).
- Dacryoadenitis (Cohen, 2007).
- Glaucoma (Bilgin et al, 2015:54; Cohen, 2007). This is rare in Sweet’s syndrome, and can also be caused by steroid medication.
- Iritis (Cohen, 2007).
- Ocular congestion.
- Optic nerve involvement (Bilgin et al, 2015:54; Jang et al, 2017; Koay et al, 2013; Lobo et al, 2011).
- Periocular cellulitis (cellulitis around the eyes), swelling around the eyes, lesions on the eyelid or around the eyes, or eye and eyelid inflammation (Bilgin et al, 2015:54; Cohen, 2007; Khatri and Taha, 2007; Morgan and Callen, 2001).
- Peripheral ulcerative keratitis (Bilgin et al, 2015; Carbonell et al, 2011; Cohen, 2007). This is rare in Sweet’s syndrome, but can cause severe inflammation and tissue damage, potentially leading to visual impairment and blindness.
- Raccoon eyes or periorbital ecchymosis.
- Retinal vasculitis (Baartman et al, 2014; Cohen, 2007). This is rare in Sweet’s syndrome, but more common in the similar condition Behcet’s syndrome. It can potentially lead to retinal ischaemia, visual impairment and blindness. See ‘Further information’ to learn more about Behcet’s.
- Scleritis (Bilgin et al, 2015; Carbonell et al, 2011; Cohen, 2007; Zaouak et al, 2017).
- Uveitis and panuveitis (Bancu et al, 2016; Cohen, 2007; Lobo et al, 2011; Matsumiya et al, 2012; Stevenson and Hannay, 2016). This is rare in Sweet’s syndrome, but uveitis is the most common eye condition in Behcet’s syndrome.
How are eye problems caused by Sweet’s syndrome diagnosed?
- A doctor will ask you about your symptoms.
- Your eyes will be examined.
- Sometimes other investigations are needed, e.g. CT scan (computerized tomography), or an eye biopsy.
Read more about diagnosis here.
How are eye problems treated?
Treatment includes systemic steroids and/or eye drops (usually steroid eye drops) depending on which part of the eye is affected or the severity of the eye condition. However, other medications may be given.
If the eyes are dry, lubricant eye drops, otherwise known as ‘artificial tears’ can be beneficial.
Read more about treatment here.
Behcet’s Syndrome Society (2016) BSS factsheets (online). Accessed 16/01/18.
Mayo Clinic (2016) Cataracts: Self- Management (online). Includes information on lifestyle and home remedies, and prevention. Updated August 2016, and accessed 16/01/18.
Neuro-Sweet’s disease: a neurological variant. This Sweet’s syndrome variant can sometimes affect vision.
Ngan, V. (2002) Behcet Disease (online). Accessed 16/01/18.
NHS Choices (2016) Dry Eye Syndrome (online). Updated 17/03/16, and accessed 16/01/18.
Baartman, B., Kosari, P., Warren, C., Ali, S., Jorizzo, J., Sato, M. and Kurup, S. (2014) Sight-Threatening Ocular Manifestations of Acute Febrile Neutrophilic Dermatosis (Sweet’s Syndrome). Dermatology, Mar;228:193–197 (Karger).
Bancu, L., Ureche, C., Craciun, N., and Marian, D. (2016) A case of Sweet’s syndrome associated with uveitis in a young male with ulcerative colitis. Romanian Journal of Morphology and Embryology, 57(3):1145-1147 (PubMed). In this case, the uveitis may be associated with the Sweet’s syndrome or ulcerative colitis.
Bilgin, A., Tavas P., Turkoglu, E., Ilhan, H., Toru, S. and Apaydin, K. (2015) An uncommon ocular manifestation of Sweet syndrome: peripheral ulcerative keratitis and nodular scleritis. Arquivos Brasileiros de Oftalmologia, Jan-Feb;78(1):53-5 (PDF).
Lobo, A., Stacy, R., Cestari, D., Stone, J., Jakobiec, F. and Sobrin, L. (2011) Optic nerve involvement with panuveitis in Sweet syndrome. Ocular Immunology and Inflammation, Jun;19(3):167-70 (PubMed).
Morgan, K. and Callen, J. (2001) Sweet’s syndrome in acute myelogenous leukemia presenting as periorbital cellulitis with an infiltrate of leukemic cells. Journal of the American Academy of Dermatology, Oct;45(4):590-5 (PubMed).
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