Tear film resembles other body fluids in many biochemical aspects. As tear sampling is a noninvasive, simple and rapid method, it may be used for diagnostic purposes regarding local or systemic disorders. Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. It may also cause Sjogren's syndrome, an inflammation of the lachrymal and salivary glands, leading to decreased production of saliva and tears and possible development of a dry mouth and dry

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... . Therefore, lachrymal and accessory glands can become a target of the immune system and show signs of inflammation, leading to possible changes in tear physiology and biochemistry. 30 RA patients and 30 controls (aged 45-55 years) were selected to enter the study. A number of analytical methods including electrophoresis, reverse-phase high-performance liquid-chromatography (HPLC) fractionations; enzyme linked immunosorbant assay (ELISA) were used to separate and display the differential tear proteome. Total tear proteins and biological activities of some important enzymes, lysozyme, lactoferrin and tyrosinase were measured using known chemical assay methods. Changes in electrophoregrams and chromatographic tear proteomic profiling patterns were observed and characterized in tears of RA patients compared to healthy volunteers. Total tear proteins and lysozyme were decreased in tear samples obtained from RA patients while lactoferrin and immunoglobulins showed about a 10% increase compared to healthy controls. Based on the results obtained from this study, it is concluded that a rheumatologist should to be aware of the association between RA and inflammatory eye disease. Changes in tear proteins and enzymatic activity may, in most cases, give rise to impaired response of the eye to external and internal factors.