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During periods of active corneal ulceration, conjunctivae and corneas of all RA patients studied contained numerous immune\u2010associated (Ia) antigen\u2010positive tissue macrophages. In 4 of 6 patients, conjunctival or corneal T cell infiltrations were present. In 2 patients, a T cell vasculitis was seen in conjunctival tissue. Conjunctival epithelial cells of all 6 RA patients expressed Ia antigens during active corneal ulceration. These data provide evidence for immune\u2010mediated mechanisms in the pathophysiology of corneal ulceration in RA. 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