Research shows the same inflammation that causes joint problems in people with psoriatic arthritis can also damage other areas of the body, including the eyes, according to the Arthritis Foundation. Eye dryness, eye pain, and conjunctivitis are some common problems associated with psoriatic arthritis. A less-frequent psoriatic eye condition is inflammation in the middle layer of the eye, known as uveitis, which can lead to permanent eye damage and vision loss if left untreated. But psoriatic arthritis eye problems can be effectively remedied if diagnosed early. “Patients have to have an understanding of what the symptoms can be,” says Mark Fisher, MD, MPH, a rheumatologist in Fall River, Massachusetts. “Vigilance is really important.” Below are some psoriatic arthritis signs and symptoms that might warrant a visit to your doctor. If you notice any psoriasis flare-ups around your eyes, consult with a dermatologist and an ophthalmologist. Treatment typically involves applying topical medication to remove the scales on the eyelids. Be sure to follow your provider’s instructions on how to apply topical treatments around the eye. Overuse of certain topicals in the eye area may increase the risk of cataracts and glaucoma, cautions the National Psoriasis Foundation. “By starting early treatment we can prevent any damage from happening,” says Dr. Fisher. “Medications really do work.” RELATED: 9 Tips to Avoid Infections When Taking Biologics for Psoriatic Arthritis
Conjunctivitis
Commonly known as pink eye, conjunctivitis is the swelling or inflammation of the conjunctiva, the thin, transparent layer of tissue that lines the inner eyelid and covers the white part of the eye. Red, itchy eyes due to conjunctivitis occur more commonly among people with psoriasis, according to the Mayo Clinic. Indeed, some research published in February 2017 in Open Access Text suggests that more than 60 percent of psoriasis patients experience conjunctivitis at some point. Symptoms of conjunctivitis include redness in the whites of the eyes, itchy eyes, and increased tearing. If you experience any signs of pink eye, get in touch with your doctor. Treatment typically involves eye drops or ointments, but may also include oral medications to treat the underlying psoriatic arthritis. RELATED: What Psoriatic Arthritis Really Feels Like About 7 percent of psoriatic arthritis patients develop uveitis, according to the Arthritis Foundation. “For patients who test positive for the HLA-B27 gene, that number may be a little higher,” notes Fisher. The HLA-B27 gene encodes an antigen that helps the immune system function. Some patients who have this gene are more likely to get inflammation in the eye. Symptoms of uveitis include eye pain, red eyes, blurry vision, floaters (seeing specks or shadows), and sensitivity to light, according to the National Eye Institute. Doctors typically begin uveitis treatment with corticosteroid eye drops, and they may also turn to other immunosuppressive medications, such as traditional disease-modifying drugs and biologic agents, says the Arthritis Foundation. With the right medication, uveitis will go away, but relapses may occur. “Once a patient is known to have uveitis, doctors usually recommend they keep a bottle of steroid eye drops so they can start treatment before they get in to see the eye doctor,” Fisher says. RELATED: Is It Psoriatic Arthritis or Fibromyalgia?
Changes in Eyelids
Rarely, people with psoriatic arthritis eye problems can develop ectropion, a serious eye condition in which the eyelids and lashes turn outward away from the eyeball. The condition, which is more prevalent in older adults, most commonly affects the lower eyelid and can be moderate (where only one part of the eyelid turns away from the eye) or severe (where the entire eyelid is turned out), says the Mayo Clinic. Symptoms of ectropion include excessive tearing or eye dryness, irritation, burning, redness or chronic conjunctivitis, and visible drooping of the lower eyelid. If you experience any signs of ectropion, seek medical help right away. “This is too serious if missed or delayed,” stresses Ana-Maria Orbai, MD, the director of the psoriatic arthritis program at the Johns Hopkins Arthritis Center in Baltimore. Although artificial tears and lubricating ointments can offer temporary relief, treatment of ectropion typically requires surgery. Additional research by Julia Califano.
