How to Protect Your Eye Health — and Preserve Your Vision — if You Have Psoriasis

If you have psoriasis, a chronic condition that primarily affects the skin, you might not know that it can also affect your eyes. But the inflammation that causes lesions on your skin is systemic, and there are several ways it can extend to your eyes.

Learn how to spot the symptoms of psoriasis-related eye problems and what to do if you develop them.

• Dry eye disease
• Blepharitis
• Conjunctivitis
• Uveitis
• Cataracts

These symptoms are common for typical eye complications.

Dry Eye Syndrome

Dry eye syndrome is an inflammatory condition. It is often chronic and can cause these symptoms:

• A dry feeling in the eye
• The feeling of a foreign body in the eye
• Blurred vision
• Light sensitivity

Blepharitis

Blepharitis is the inflammation of the eyelids. There are two types: Anterior blepharitis tends to affect the lash line, where the eyelashes attach to the eyelid; and posterior blepharitis affects the water line of the eyelids, which is the line of skin between the eyelashes and the eye.

Symptoms of blepharitis include the following:

• Red, swollen eyelids
• Slight flaking of the eyelid
• Itching and burning sensations in the eyes
• Dry eyes

Conjunctivitis

Common symptoms of conjunctivitis include the following:

• Redness or itchiness in one or both eyes
• A gritty sensation in one or both eyes
• Discharge in one or both eyes
• Heavy tearing
• Sensitivity to light

Uveitis

If left untreated, uveitis causes irreversible damage to the eyes, including partial vision loss or even blindness.

Symptoms of uveitis include the following:

• Eye redness
• Light sensitivity
• Blurry vision
• Floaters (small specks or spots in your field of vision)
• Eye pain

Cataracts

The symptoms of cataracts include the following:

• Double vision
• Cloudiness or loss of vision in the eye
• Poor night vision
• Sensitivity to light

“Psoriasis is associated with systemic inflammation, which can extend to ocular structures,” says Arthi Venkat, MD, an ophthalmologist at UVA Health in Charlottesville, Virginia. “Both psoriasis and uveitis are inflammatory autoimmune conditions, meaning the immune system mistakenly attacks the body’s own tissues. In addition, topical and systemic steroids that might be used to treat psoriasis and psoriatic arthritis can lead to adverse effects on the eye, such as glaucoma and cataracts.”

“Patients with psoriasis should have regular eye exams, even if they are asymptomatic, to catch early signs of inflammation,” says Dr. Venkat. While there aren’t specific screening protocols for people with psoriasis, comprehensive annual eye exams are necessary to look for early symptoms of uveitis and screen for glaucoma, she says

Treatment for psoriasis-related eye problems can vary based on severity. In most cases, prescription corticosteroid eye drops are the first-line treatment. However, if uveitis recurs or becomes chronic, medical providers may prescribe an immunosuppressant drug. These drugs suppress an overactive immune system, which can be the root cause behind the inflammation often associated with psoriasis.

Other treatments focus on the symptoms of psoriasis-related eye problems. Scales and dryness on the skin of the eyelids from blepharitis may cause them to curve up or down, which may lead to drying of the cornea (the clear layer on the front of the eye) or enable your eyelashes to scratch the surface of the cornea, damaging it and, potentially, your vision.

• Wash your eyelids and lashes with a mixture of water and baby shampoo.
• Use an over-the-counter eyelid cleaner to remove scales.
• Use artificial tears.
• Apply warm compresses to the eyes.
• Apply a prescription topical medication, such as pimecrolimus (Elidel) or tacrolimus (Protopic), around the eyes, if recommended by your doctor.

In addition to medical treatments, you can take steps to lower your risk of developing serious eye problems.

Dr. Stokkermans recommends reducing stress, maintaining a healthy diet, and getting adequate sleep to help prevent psoriasis flares. He also says that it’s important to take smoking cessation seriously.

• The systemic inflammation that causes skin lesions in psoriasis can also impact the eyes.
• Symptoms of eye complications such as eye redness, itching or burning, dryness, and blurry vision should be taken seriously.
• Having annual eye exams can help catch eye problems early and prevent lasting damage to your eyes.