People with both mild and severe psoriasis have an increased risk of uveitis, a potentially severe eye inflammation. People with concurrent severe psoriasis and psoriatic arthritis have the highest risk for uveitis.

Over the past decade, there has been an increasing awareness of the co-morbidities of psoriasis by exploring the other inflammatory diseases that are linked to psoriasis and arthritic psoriasis.  This has led to the introduction of the term psoriatic disease to highlight its multi-organ involvement. As if being spotty isn’t enough for us, uveitis is one of those inflammations that is on the spectrum of psoriatic disease and therefore we are vulnerable to this inflammatory eye degeneration.

Two studies confirmed the link between uveitis and psoriasis. A Singaporean study that found that the severity of psoriasis correlated with the presence of uveitis, and a study that was conducted in Taiwan between January 2000 and December 2012 of almost 148,000 participants with psoriasis and 148,000 non-psoriatic participants who were the control. Both results found that the following people were at risk of developing uveitis:

• people with concurrent severe psoriasis and psoriatic arthritis had the greatest risk
• people with severe psoriasis but without psoriatic arthritis had an increased risk
• those with mild psoriasis and psoriatic arthritis had a lower risk.

There was not an increased risk for uveitis with mild psoriasis but without psoriatic arthritis. Although the association between psoriatic arthritis and uveitis is well known, the relation between uveitis and psoriasis without psoriatic arthritis was rarely examined.

Uveitis

Uveitis is a general term describing a group of inflammatory diseases that produces swelling and destroys eye tissues. These diseases can slightly reduce vision or lead to severe vision loss. Uveitis inflammation affects the uvea, the lens, retina, optic nerve, and vitreous, producing reduced vision or blindness. Uveitis is caused by inflammatory responses inside the eye and psoriasis is one of the diseases associated with uveitis.

Uveitis can affect one or both eyes. Symptoms may develop rapidly and can include:

• Blurred vision
• Dark, floating spots in the vision (floaters)
• Eye pain
• Redness of the eye
• Sensitivity to light (photophobia)

How this affects you

This study found that people with severe psoriasis and psoriatic arthritis have the highest risk of uveitis, while those with mild psoriasis and psoriatic arthritis and those with severe psoriasis but without psoriatic arthritis have a moderately increased risk of incident uveitis.

Psoriasis patients who meet one of these risk criteria should be aware of the increased risk and manifestations of uveitis and focus their attention on their eye health.  Any psoriatic who is also suffering eye pain, severe light sensitivity, and any change in vision should immediately be examined by an ophthalmologist.

References

Chi C, Tung T, Wang J, et al. Risk of Uveitis Among People With Psoriasis A Nationwide Cohort Study. JAMA Ophthalmol. 2017;135(5):415–422. doi:10.1001/jamaophthalmol.2017.0569