Psoriasis is more than just a skin disease. It can cause joint damage, known as psoriatic arthritis, which has been linked to cardiovascular risk including heart attacks and can also affect the health of 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 damage and vision loss.
Although they are relatively rare, psoriasis flare-ups near the eyes can be especially painful and hard to treat.1 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.
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 cleaner to remove stubborn scales.
- Apply a topical medication around the eyes. These medications are only available by prescription and should be used with your doctor’s supervision.
- Have your intraocular eye pressure (IOP) tested by tonometry 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, due to the risk of cataract and glaucoma development, you should not continue the use of these steroids beyond the time recommended by your doctor.
Uveitis and Iritis
Frequently, uveitis and iritis arise as a complication of a disease, such as psoriatic arthritis or lupus. Such diseases cause the body’s immune system to attack their healthy tissue.
Uveitis is an inflammation of the uvea, the middle layer of the eye’s surface. The uvea includes the iris, which makes up 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 be localized to the ciliary body, too, which produces aqueous humor—the fluid that fills the eye. It can also be localized to the choroid, which are 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
Because of the connection between psoriasis and uveitis, your ophthalmologist may want to consult your primary care physician, your rheumatologist, 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.1
People who have uveitis associated with psoriasis are more likely to have recurrent problems with uveitis than those who do not have psoriasis and other autoimmune disorders. If uveitis has become a recurring issue, you may find it helpful to reach out to others with the same problem.