Because psoriatic arthritis (PsA) is a condition that affects the joints, most people are unaware that the genetic and environmental factors that cause psoriatic arthritis can also impact your eyes. The National Psoriasis Foundation notes that having psoriatic disease increases your chances of developing eye disorders. Although PsA is less frequently diagnosed in Blacks, Blacks are more severely impacted by psoriatic disease. So exactly how does PsA affect your eyes?
What is the connection between the eyes and PsA?
PsA can impact both the outside and inside of your eyes.
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“The connective tissues of the eyes and joints share similarities. They both contain collagen and hyaluronic acid, and that may explain eye involvement,” Tim Barr, M.D., an optometrist at Island Eye Care, in Kent Island, MD says. “It also may be the nature of the type of inflammation triggered by autoimmune disease.”
About half of people with PsA experience psoriasis on their face, which can cause plaques to form around the eyes. These plaques can cover your eyelids or lashes and prevent them from working properly and leading to further irritation.
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3 eye conditions caused by PsA
Dry Eyes
This is one of the most common eye issues with PsA, Dr. Barr notes. It affects between 3% to 19% percent of people with PsA. Symptoms of this condition, which causes inflammation of the eye glands include slight irritation and burning in mild disease to severe pain and blurred vision.
Your doctor will diagnose dry eye through a comprehensive eye exam that examines the quality and quantity of your tears.
Treatment for dry eye consists of lubricating the eyes and minimizing dryness.
Conjunctivitis
Conjunctivitis or pink eye can also be caused by psoriatic disease. A 2020 article in The Journal of Family Medicine and Primary Care found that more than 64% of people with psoriasis had experienced conjunctivitis.
“Conjunctivitis is inflammation of the clear covering that lines your eyelid and covers the white part of your eyeball,” Dr. Barr explains. It can be either bacterial or viral, however, viral is more common.
Treatment for pink eye consists of relieving symptoms by using artificial tears, cleaning your eyelids, and applying cold or warm compresses.
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Uveitis
People with psoriatic arthritis (Between 7% and 40%) have a much higher risk of developing uveitis than the general population (0.1%). It can be an early sign of PsA and occur in people who have not developed joint issues. Uveitis can come and go depending on stress, weather, or other triggers.
Symptoms include:
- Eye redness
- Eye pain
- Light sensitivity
- Blurred vision
- Dark, floating spots in your field of vision (floaters)
- Decreased vision
Knowing the symptoms of uveitis is important because getting treatment as soon as possible will prevent vision loss.
The goal of treatment is to reduce the inflammation in your eye and other parts of your body. “Uveitis is typically treated with steroid eye drops in combination with oral medications to treat the underlying PsA,” says Dr. Barr. Antibiotics, antiviral medications, or other medicines, with or without corticosteroids may also be prescribed if uveitis is caused by infection.
How quickly you recover depends on the severity of your symptoms and which part of your body is affected.
How to treat psoriasis around the eyes
If you are suffering from eye psoriasis, contact your dermatologist. He or she can provide several treatment options including topical meds, mild steroids for your face, and potent steroids to treat your whole body.
“If you have a flare around your eyelids, you should begin utilizing the mild-to-moderate topical steroid that has been prescribed by your doctor, ideally on the first day of your flare,” Aaron Farberg, M.D., dermatologist and dermatologic surgeon at Baylor University Medical Center in Dallas, TX. says. “There are other non-steroidal alternatives, which are particularly useful in sensitive areas such as the eyelids.”
Finding the right treatment may take some trial and error, however, once you find something that works; it can be your go-to protocol for future flare-ups.
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Making lifestyle changes
Making changes to your daily routine to reduce inflammation can greatly help your joints, skin, and eyes. “Consuming a diet rich in fruits, vegetables, and omega 3 fatty acids while avoiding foods that can promote inflammation, such as processed or red meat and dairy products, can help keep your eyes as healthy as possible,” Dr. Barr adds. “Stress reduction and exercise are also important and play a positive role in your eye health.”
Prioritizing your eye health will be important if you are living with psoriatic arthritis. Having an annual eye exam and letting your eye doctor know of your psoriatic arthritis diagnosis is the best way to detect changes to your eyes early and get treated right away. With these lifestyle changes, you'll be able to live a healthy life with PsA.
