Acute myopic shift in a patient with systemic lupus erythematosus

PURPOSE: To describe a rare case of acute, transient myopic shift occurring as a feature of a flare of systemic lupus erythematosus. OBSERVATIONS: A 22-year-old Indigenous Australian woman with diagnosed systemic lupus erythematosus was admitted with blurry vision and periorbital oedema. She had a refractive error of −7.50 DS in the right eye and −3.50 DS in the left eye and cotton wool spots throughout the posterior poles of the retina of each eye. Treatment with intravenous and oral steroids resulted in rapid resolution of myopia and improvement in visual acuity. CONCLUSIONS AND IMPORTANCE: Systemic lupus erythematosus disproportionately affects more indigenous than non-indigenous Australians with greater disease burden and severity. This case describes a rare manifestation of this disease.