Psoriatic Arthritis and Uveitis

For people with psoriatic arthritis (PsA), achy and painful joints are not the only symptoms to deal with. PsA also increases the risk of developing uveitis. Uveitis is a term used to describe inflammation of the eye. It causes redness and pain, and it can lead to vision loss.^1,2

What is uveitis?

Uveitis refers to inflammation of the uvea, the middle layer of the eye between the white part of the eye (sclera) and the innermost layer of the eye (retina). Uveitis can also affect the other structures in the eye, including the lens, optic nerve, and the vitreous body, a gel-like fluid that is attached to the retina.^1,3

Who does it affect?

About 7 percent of people with PsA will develop uveitis. Uveitis can occur at any age, but it is most often seen in people age 20 to 60.^1,3

Uveitis has also been shown to affect people living with other autoimmune diseases. For instance, those with rheumatoid arthritis and lupus are at an increased risk of developing uveitis.^1,3

What are the symptoms?

Uveitis symptoms can occur gradually or develop more rapidly. They can range from being merely annoying to severe. Sometimes, they can threaten a person’s vision. As with other PsA symptoms, the severity of uveitis varies from person to person.^1,2

Uveitis can affect one or both eyes. Symptoms of uveitis include:^1,2

• Blurry vision
• Dark, floating spots in the vision (floaters)
• Redness of the eye
• Eye pain
• Sensitivity to light (photophobia)
• Small or irregular-shaped pupils

How is uveitis diagnosed?

Uveitis can occur in the early stages of PsA development or during the later stages of the condition. Eye inflammation can be an indicator of early-stage PsA. This is why it is important to get your eyes checked regularly, especially if you have psoriasis, an inflammatory skin condition linked with PsA.^1,2

Uveitis is diagnosed by an eye doctor (ophthalmologist). A uveitis diagnosis involves one or more of the following:^3,4

• Vision test – Your doctor will use an eye chart to test your vision.
• Dilated eye exam – This exam uses eye drops that dilate the pupil, which allows the doctor to view the back of the eye.
• Tonometry – This exam measures the pressure inside the eye.
• Slit lamp exam – A slit lamp is a special microscope with a bright light that your doctor can use to get a closer look at the front of your eye and inside your eye.

Complications of uveitis

If uveitis is not diagnosed or treated early, it can lead to complications. These may include:⁵

• Permanent vision damage
• Cataracts, when the lens of the eye becomes clouded
• Fluid within the retina
• Glaucoma, an eye disease that damages your eye’s optic nerve, which results in vision loss
• Retinal detachment, an emergency situation that can cause vision loss
• Vision loss or blindness

Early diagnosis and appropriate treatment of uveitis can help reduce the risk of these complications.

How is uveitis treated?

The ultimate goal of treating uveitis is to reduce the inflammation in the eye in order to save vision and reduce complications. Steroids and systemic drug treatments are most often used. These treatments can be given in a number of ways, such as:^1,3,4

• Anti-inflammatory steroids: These may be taken as eye drops, oral medicine, or eye injections.
• Steroid-releasing implant: This is a device that is surgically implanted into the eye and slowly releases steroids to control inflammation.
• Biologic drugs: These medicines are often prescribed to fight PsA symptoms and can be helpful in treating eye and joint inflammation.

Early treatment of PsA can reduce the risk of long-term complications like uveitis. If you have any eye pain, sensitivity to light, or any change in vision, make an appointment with an ophthalmologist as soon as possible to have your eyes examined.^1,2,4