June 13, 2024

The condition “we worry about most with the eye is called uveitis,” says Greer. The uvea, as the American Academy of Ophthalmology (AAO) explains, is the layer of tissue between the retina and sclera, including the iris. When the uveal tract becomes inflamed, symptoms can include blurred vision, redness of the eyes, eye pain, and sensitivity to light.

Uveitis can affect the entire eye — the anterior (front), the intermediate area, and the posterior part where the retina is located. Greer notes that you can have panuveitis where all three parts of the eye are affected, or it could be in the middle or anterior parts of the eye. If not treated properly, uveitis can lead to vision loss.

Greer notes that some psoriatic arthritis patients can present with uveitis as their first manifestation of psoriasis or arthritis. “They have eye inflammation first, they see the ophthalmologist, they may have a patch of psoriasis somewhere, and people don’t realize there’s a connection.”

Initial treatment for uveitis typically includes corticosteroid eye drops to reduce the inflammation, notes the AAO. Prolonged use of corticosteroid eye drops, however, can eventually cause side effects including glaucoma and cataracts, notes Greer.

If a patient has recurring episodes of uveitis, more systemic disease treatment is necessary. This includes medications such as methotrexate and newer biologic drugs such as adilimumab (Humira), which is approved to treat uveitis.

“We have to give serious consideration to treating [patients] systemically to prevent eye damage,” says Greer. This means using the right systemic medications, as some treatments for psoriatic arthritis (such as IL-17inhibitors) do not work in the eye.

About 7 percent of people with psoriatic arthritis develop uveitis, according to the National Psoriasis Foundation. There’s also a genetic component. The gene for the human leukocyte antigen HLA-B27 is common in people with spondyloarthropathies, according to the Arthritis Foundation.

“When a patient has HLA-B27 with one of these spondyloarthritis diseases, it can also be a risk factor or predictor of eye damage, of uveitis,” says Greer.

While there are other forms of inflammation of the eye, such as vasculitis of the eye, they are less common with psoriatic arthritis and more prevalent in rheumatoid arthritis, notes Greer.

RELATED: Uveitis: The Eyesight Threat Linked to Psoriatic Arthritis


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