Eye Problems Related to Psoriasis, Uveitis, and Iritis

Senior man rubbing eye. Brad Wilson/ GettyImages

Psoriasis is more than just a skin disease. It can cause joint damage, known as psoriatic arthritis, and it has been linked to cardiovascular risk, including heart attacks. And, psoriasis can also affect your eyes.

Eye problems may be directly related to psoriasis skin flare-ups around the eyes. But psoriasis can also lead to problems within the eye itself — problems that when left untreated can cause permanent vision loss.

Psoriasis Flare-ups Around the Eyes

Although they are relatively rare, psoriasis flare-ups near the eyes can be especially painful and hard to treat. Scales and dryness may cause the edges of the eyelids to curve up or down, which may produce drying of the cornea (the clear layer on the front of the eye) or allow the eyelashes to scrape the cornea of the eye.

In such cases, the National Psoriasis Foundation recommends the following:

  • Wash the affected lids and lashes with a mixture of water and baby shampoo.
  • Use an over-the-counter eyelid cleanser such as OCuSOFT to remove stubborn scales.
  • Apply a topical medication such as Elidel (pimecrolimus) around the eyes. You need a doctor's prescription to buy Elidel.
  • Have your intraocular eye pressure tested regularly by an ophthalmologist to ensure that these topical treatments aren't harming your eyes.

Dermatologists will sometimes prescribe low-potency steroids for use on the eyelids.

This can help, but because of the risk of cataracts and glaucoma if you use steroids for too long, patients should not continue use of these steroids beyond the time recommended by their doctor. The medication Protopic (tacrolimus) has also been shown to be very effective for treatment of eyelid psoriasis.

Uveitis and Iritis

Uveitis and iritis frequently arise as a complication of a disease, such as psoriatic arthritis or lupus, in which the body's immune system attacks its own healthy tissue.

Uveitis is an inflammation of the uvea, which is the middle layer of the eye's surface. The uvea includes the iris, the colored area at the front of the eye. When uveitis is localized at the front of the eye, it's called iritis (or anterior uveitis).

Uveitis can also be localized to the ciliary body, which produces aqueous humor — the fluid that fills the eye. Finally, uveitis can also be localized to the choroid, which is the small blood vessels behind the retina.

Symptoms of uveitis can include:

  • redness in the eye
  • sensitivity to light
  • blurred vision
  • "floaters" in the field-of-vision
  • pain in the eye

A diagnosis can only be made after an examination by an ophthalmologist, who'll also look for any other problems in the eye, such as cataracts or glaucoma. Because of the connection between psoriasis and uveitis, your ophthalmologist may want to consult your primary care physician or any specialists you are seeing to determine a treatment plan.

In most cases, corticosteroid eye drops given at home will clear any inflammation. In recurring cases, a systemic drug that suppresses your immune system may be needed to fight the root cause of the inflammation. If other problems — such as glaucoma or cataracts — are diagnosed along with uveitis, surgery may be necessary.

Early detection and treatment are of the utmost importance. Untreated uveitis can cause irreversible damage to the delicate eye tissue, and it represents the third most common cause of preventable blindness in the nation.

How to Cope with Uveitis

If uveitis has become a recurring issue, you may find it helpful to reach out to others with the same problem. For coping with psoriasis in general, the National Psoriasis Foundation website provides information about finding psoriasis support groups across the United States, and it provides an online community.

Sources:

Foundation of the American Academy of Ophthalmology. Uveitis fact sheet. Accessed Feb. 24, 2016.

National Psoriasis Foundation. Psoriasis Around the Eyes, Ears, Mouth and Nose fact sheet. Accessed May 22, 2008.

National Psoriasis Foundation. Uveitis: A Threat to Eyesight fact sheet. Accessed Feb. 24, 2016.

Ocular Immunology and Uveitis Foundation. Systemic Treatment of Ocular Disease. Oct. 2005. Ocular Immunology and Uveitis Foundation. Accessed May 22, 2008.

University of Michigan Kellogg Eye Center. Uveitis (Iritis). University of Michigan Kellogg Eye Center. Oct. 2005. University of Michigan. Accessed May 22, 2008.

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