Ophthalmic manifestations of celiac disease in Tabuk City, Saudi Arabia.

Background: Celiac disease (CD) is an autoimmune enteropathy affecting approximately 0.7-1.4% of the global population. However, extraintestinal manifestations of CD, particularly ophthalmic conditions, remain underrecognized. This study aims to describe the spectrum and frequency of ophthalmic manifestations among a cohort of patients with CD in Tabuk, Saudi Arabia. Methods: This 5-year retrospective observational study was conducted at a tertiary care center and included 83 patients with CD, with no age restrictions. Patients were identified through the hospital's electronic medical records using a diagnosis of CD established by a gastroenterologist based on standard clinical, serological, and/or histopathological criteria. Ophthalmic manifestations were retrieved from comprehensive ophthalmic examinations documented by ophthalmologists. For analysis, participants were stratified into pediatric (≤14 years) and adult (>14 years) groups based on their age at the time of data collection. Results: Ophthalmic manifestations were identified in 37.3% (95% CI: 27.0 to 48.7%) of the reviewed patient records. The most common ocular manifestations included refractive errors (12, 95% CI: 5.9 to 21.0%), followed by allergic conjunctivitis and dry eye disease (each 4.8, 95% CI: 1.3 to 11.9%). No significant associations were observed between age groups or diabetes mellitus and the prevalence of individual ophthalmic diagnoses. However, when ophthalmic involvement was analyzed as a composite outcome (defined by the presence of any ophthalmic disorder), a multivariable logistic regression analysis demonstrated that older age (adjusted OR: 3.25, 95% CI: 1.09 to 9.66, Conclusion: In this cohort, ophthalmic findings were documented in over one-third of patients with CD. However, the prevalence of refractive errors was comparable to that reported in the general population, and due to the absence of a control group, a disease-specific association between CD and ophthalmic manifestations could not be established. Nevertheless, adults and patients with co-occurring diabetes demonstrated a higher likelihood of ocular involvement. These results highlight the need to raise awareness of ocular findings in patients with CD among healthcare professionals. Future controlled studies, particularly matched case-control or prospective cohort designs, are recommended to better assess these potential associations.