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Psoriasis and Your Eyes

By Lia Tremblay

Updated July 04, 2008

(LifeWire) - 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. Psoriasis can also affect your eyes.

Eye problems may be directly related to 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.

Flare-ups Around the Eyes

Although it is relatively rare, 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 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 (Cynacon, Richmond, Texas) to remove stubborn scales.
  • Apply a topical immunosuppressant, such as Elidel (pimecrolimus) around the eyes. Elidel is a prescription medication that must be prescribed by your doctor.
  • Have your intraocular eye pressure tested regularly by an ophthalmologist to ensure that topical treatments aren't harming your eyes.

Dermatologists will sometimes prescribe low-potency steroids for use on the eyelids. This is appropriate, but because of the risk of cataracts and glaucoma, patients should not continue use of these steroids beyond the time recommended by their doctor. 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, 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. 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 concurrent 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 immunosuppressive drug 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 is 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

If uveitis has become a recurring issue, you may find it helpful to reach out to others with the same problem. There are support groups for uveitis, including an online support group hosted by The Ocular Immunology and Uveitis Foundation, which includes instructions on how to adjust the appearance of the site for users with vision loss.

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 Staff, "Uveitis." AAO.org. May 2007. Foundation of the American Academy of OphthalmologyU. 22 May 2008 <http://www.aao.org/eyecare/conditions/uveitis/index.cfm>.

National Psoriasis Foundation Staff, "Psoriasis Around the Eyes, Ears, Mouth and Nose." Psoriasis.org. Oct. 2005. National Psoriasis Foundation. 22 May 2008 <http://psoriasis.org/about/psoriasis/sites/eyes.php>.

Ocular Immunology and Uveitis Foundation Staff, "Systemic Treatment of Ocular Disease." Uveitis.org. Oct. 2005. Ocular Immunology and Uveitis Foundation. 22 May 2008 <http://www.uveitis.org/patient/articles/articles/sys.html>.

University of Michigan Kellogg Eye Center Staff, "Uveitis (Iritis)." University of Michigan Kellogg Eye Center. Oct. 2005. University of Michigan. 22 May 2008 <http://www.kellogg.umich.edu/patientcare/conditions/uveitis.html>.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Lia Tremblay is a freelance writer and editor specializing in consumer health care topics. She lives and works in Virginia.

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