Psoriasis and eyes

The relationship between the eye and psoriasis has been recognized for decades, but the precise ocular manifestations in patients with psoriasis and psoriatic arthritis which occur in approximately 10% of patients are only recently coming to light. Psoriatic eye changes include conjunctivitis, dry eye, and uveitis. Uveitis has been reported more frequently in patients with arthritis (7–25%), but sometimes in psoriatic patients without arthritis.

Dermatologists have to remember about side effects of the therapy. Care should be taken when prescribing corticosteroids because of corticosteroid induced glaucoma, retinoids for ocular manifestations including photophobia, conjunctivitis, keratitis, and dry eye. PUVA therapy does not substantially increase risk of cataract, while psoralens and corticosteroid therapy can have an influence on the development of opacification. Therefore during PUVA therapy patients should use eye protection to prevent increasing risk of cataract and corneal lesions.

Untreated ocular disease may have serious consequences, therefore dermatologists should be aware of the possibility of eye changes in psoriatic patients. We recommend regular surveillance of these patients for visual changes and eye symptoms. Collaboration between ophthalmologists and dermatologists is essential to optimize disease management.