Check Out Those Peepers: Psoriasis and Risk of Eye Problems
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Did you know people with psoriasis and psoriatic arthritis have an increased risk of eye problems? Because of this, it is recommended that people with psoriasis see an ophthalmologist (an eye specialist) immediately if you ever have vision blurring, loss, or other problems with your eyes1.

In our Psoriasis In America 2016 survey, 19% of people say they have experienced eye disorders or issues as a complication of their psoriasis, which is somewhat higher than what is reported in the literature.

People with psoriasis are somewhat more likely than the “average” person to develop eye problems. For people that also have psoriatic arthritis, this risk is significantly pronounced (0.1% vs. 7-10%)2.  Of the eye problem that people with psoriasis develop, the most common is Uveitis, which is an inflammatory disease process internal to the eyes (intraocular)3.

What are the symptoms?

Uveitis refers to a group of inflammatory diseases of the eye from various causes that produce swelling and destroy eye tissue. Symptoms of uveitis include vision loss which can range from slight to severe loss of vision3.

Other symptoms of uveitis include:

  • Blurry vision
  • Dark, floating spots in the vision (floaters)
  • Eye pain
  • Redness of the eye
  • Sensitivity to light (photophobia)

Uveitis can affect one or both eyes, and symptoms often develop rapidly. In some people, however, symptoms may occur more gradually. Other autoimmune conditions, such as rheumatoid arthritis and lupus, are also known to be associated with an increased risk of uveitis4.  Along with these autoimmune conditions, it is possible that there are common genetic factors that make people with psoriasis and psoriatic arthritis more prone to developing inflammatory eye disorders such as uveitis5.

Uveitis can cause permanent damage to eyes and your vision, even with treatment. Additional complications can include cataracts, glaucoma, retinal detachment, and vision loss or blindness.

What does research tell us about treatment options?

Few studies have evaluated the association of uveitis and psoriasis for people that do not also have joint involvement of psoriatic arthritis5.  An association between Uveitis and chronic plaque psoriasis has also been found, and among patients in this research, uveitis tends to be in both eyes (bilateral), prolonged and more severe. People with pustular psoriasis are also more likely to develop Uveitis compared to people with other forms of psoriasis.

Early treatment is important to reduce the risk of complications, and patients with eye pain, severe light sensitivity, or any change in vision should immediately see an ophthalmologist for examination3. In addition, periodic ophthalmic examination should be performed in patients with psoriasis and uveitis.

A common treatment for uveitis is prednisone or another corticosteroid. Steroidal anti-inflammatories may be taken as eye drops, pills, injections around or into the eye, intravenous (IV) administration, or a capsule that is surgically implanted inside the eye3.

If you are already on an anti-inflammatory drugs or immune-modulators, those drugs may help prevent vision loss. However, oral steroids can cause debilitating side effects, including cataracts, glaucoma (also eye disorders) and in some cases can worsen psoriasis4.

More studies are required to further characterize and understand the association between psoriasis and uveitis, including relationships among inflammatory processes, psoriasis severity and the impact of psoriasis treatment on the course of intraocular disease progression5.

view references
1. Ogdie A, Schwartzman S, Eder L, Maharaj AB, Zisman D, Raychaudhuri SP, Reddy SM, Husni E. Comprehensive treatment of psoriatic arthritis: managing comorbidities and extraarticular manifestations. J Rheumatol. 2014 Nov;41(11):2315-22. 2. National Eye Institute. Accessed online on 4/16/16 at https://nei.nih.gov/health/uveitis/uveitis. 3. Medline Plus, U.S. National Library of Medicine. Accessed online on 4/16/16 at https://www.nlm.nih.gov/medlineplus/. 4. Mease PJ, Armstrong AW. Managing patients with psoriatic disease: the diagnosis and pharmacologic treatment of psoriatic arthritis in patients with psoriasis. Drugs. 2014 Mar;74(4):423-41. 5. Fraga NA de A, de Oliveira M de FP, Follador I, Rocha B de O, Rêgo VR. Psoriasis and uveitis: a literature review. Anais brasileiros de dermatologia. 2012;87(6):877-883. doi:10.1590/S0365-05962012000600009.
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