A 52-year-old woman with erosive seropositive RA, high titres of rheumatoid factor and anti-cyclic citrullinated peptide antibodies (anti-CCP) for 12 years, with secondary failure to infliximab and adalimumab. He presented with red eye, pain and photophobia. Examination: peripheral corneal infiltrate in crescents associated with scleritis. Negative culture of the corneal scraping. We started treatment with prednisone 1mg/kg/day orally and decided to change the therapeutic target to rituximab at the usual dose in RA with methotrexate 25mg/week. After the first cycle of rituximab the patient experienced great improvement with cure of the QUP and went into clinical remission of RA. After 10 months, a corneal infiltrate and mild scleritis reappeared, as well as the onset of joint symptoms. We decided to continue treatment with i.v. rituximab every 8 months with good clinical control of both ocular and systemic symptoms.