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How Does Psoriatic Arthritis Affect Your Eyes?
Psoriatic arthritis (PsA) has been associated with eye conditions, such as conjunctivitis, uveitis, and dry eyes, among others. Several treatment options may help relieve symptoms.
Psoriatic arthritis (PsA) is a chronic, inflammatory autoimmune condition associated with the skin condition psoriasis.
PsA most commonly causes swelling, stiffness, and pain in your joints as well as scaly, itchy skin lesions.
However, in some cases, PsA may also affect your eyes. This may cause uncomfortable symptoms and lead to several complications, such as vision loss.
Keep reading to learn more about eye conditions that are associated with PsA and how they are treated.
Research suggests that up to 70% of people living with psoriasis experience eye-related symptoms, such as:
In people with PsA, these symptoms may be caused by the condition's inflammation, an eye condition, or other causes unrelated to PsA. For example, dry eyes and blurred vision are symptoms of Sjögren's disease, which may affect people with PsA.
If you experience eye symptoms and PsA, it's important to get an assessment from a healthcare professional like an optometrist or ophthalmologist. They could diagnose the underlying cause and provide a treatment plan.
Typically, the surface of your eye is covered by a tear film made up of watery, oily, and mucous layers. This helps lubricate and protect your eye.
However, if your eyes don't produce enough tears or your tears evaporate too quickly, you may experience dry eyes.
Symptoms of dry eyes may include:
In some cases, dry eye may develop without noticeable symptoms, which can occur in Sjögren's disease.
Treatment for dry eyes will depend on several factors, such as the underlying cause and severity of your symptoms. This may include:
If meibomian gland dysfunction is causing dry eyes, treatment will focus on unblocking your eyelid glands. This may include topical, oral, or eye drop medications like antibiotics or steroids. It may also include at-home remedies like warm compresses and regular eyelid hygiene.
According to the National Psoriasis Foundation, approximately 7% of people with PsA will develop uveitis.
Uveitis is a condition in which inflammation occurs in the uvea of the eye. The uvea is the middle layer of your eye and includes the iris, ciliary body, and choroid.
Uveitis can affect all or some parts of your uvea.
For example, anterior uveitis is a type of uveitis that affects only the iris, also known as iritis. It occurs when white blood cells collect in the anterior chamber of the eye.
Symptoms of uveitis may include:
Speak with a healthcare professional if you notice any of these symptoms. Early diagnosis and treatment can help prevent complications, such as:
Conjunctivitis is inflammation that occurs in the conjunctiva of the eye. It's sometimes known as pink eye, especially when it results from an infection.
The conjunctiva is a thin layer of tissue that covers the whites of your eyes and the inside of your eyelids. When it gets inflamed, the edges of the whites of your eyes become red and irritated.
Research suggests that conjunctivitis is a common ocular complication of psoriasis and may occur for several reasons, including:
Symptoms of conjunctivitis may include:
Treatment for conjunctivitis depends on the cause. If a doctor suspects you have conjunctivitis due to a bacterial infection, they may prescribe antibiotic eye drops.
In other cases, they may recommend lubricating or steroid eye drops to reduce symptoms until the condition resolves on its own.
Ectropion occurs when the bottom eyelid turns outwards.
If you have skin psoriasis as well as PsA, scaly patches may develop on your face, around your eyes, and on your eyelids. This can potentially change the shape of your eyelids. In some cases, it can result in ectropion.
Symptoms of ectropion may include:
Treatment for ectropion may involve surgery. A doctor will remove extra skin and reshape your eyelid back to normal.
Speak with a healthcare professional if you notice a change in your vision or how your eyes are feeling.
They can help you identify the cause of your eye symptoms, such as whether it's related to PsA or another medical condition.
Leaving an eye condition untreated may put you at risk of complications, including vision loss in severe cases.
Can psoriatic arthritis affect the eyes?Yes, psoriatic arthritis has been associated with several eye conditions, including dry eyes, uveitis, and conjunctivitis, among others.
What are the red flags of psoriatic arthritis?The most common psoriatic arthritis (PsA) symptoms to look out for include swelling, stiffness, and pain that affect the joints in your knees, fingers, and toes. Other symptoms may include nail pitting and dactylitis, which is when your fingers resemble sausages.
What are the symptoms of psoriasis in the eyes?Symptoms of psoriasis that affect your eyes may include a burning, itching, or gritty sensation in your eyes. You may also experience inflammation, dry skin, and lesions on your eyelids and the areas surrounding your eyes.
What is the life expectancy of a person with psoriatic arthritis?A 2023 study that followed participants with psoriasis and psoriatic arthritis (PsA) from 2000 to 2017 found that they decreased life expectancy by 6.41 and 6.48 years, respectively. The main contribution to a decreased life expectancy is considered to be related to the increased risk of cardiovascular disease, which is related to chronic inflammation.
That said, PsA affects everyone differently. Speak with a healthcare professional about your outlook.
Although PsA is mainly associated with pain and inflammation of the joints, it may also increase your chance of developing certain eye conditions.
If you develop symptoms of inflammation or other problems in your eyes, contact a doctor or eye care professional. They can help develop a plan to relieve the symptoms and keep your eyes healthy.
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PsA is a chronic inflammatory condition that causes stiff and painful joints, back pain, swollen fingers, and other symptoms. A rheumatologist diagnoses and treats diseases that affect the bones, joints, and muscles. They may partner with your primary care doctor to monitor PsA progression and prescribe treatments such as lifestyle changes and medication.
Many people with PsA have already been diagnosed with psoriasis, which causes inflamed skin patches that can be painful or itchy. You may already work with a dermatologist, who specializes in assessing and managing skin conditions with treatments such as light therapy or medication.
PsA can cause uveitis, which is inflammation in the eye that may cause pain, redness, and vision changes. An ophthalmologist is a doctor who specializes in eye health. They examine your eyes and prescribe treatment such as medication if necessary.
People with PsA have increased risk of inflammatory bowel disease (IBD), which causes symptoms such as cramps and diarrhea. A gastroenterologist diagnoses and treats conditions of the gastrointestinal (GI) tract. They may prescribe medication or adjust your regimen, since some PsA medications also treat IBD.
An occupational therapist evaluates your ability to perform daily activities and meet your goals. They may adjust your tasks and environment or recommend assistive devices to help improve quality of life with PsA. A physical therapist can teach you exercises to strengthen muscles, maintain range of motion, and promote joint stability. They may use techniques like cold therapy or massage to ease joint pain.
Obesity promotes inflammation and adds stress to your joints, which can aggravate PsA symptoms and increase the risk of complications. A well-managed diet may help you lose weight, lower inflammation, and support overall health. A registered dietitian can design a sustainable, balanced diet plan.
People with PsA have increased risk of anxiety and depression. And psychological stress may impact PsA symptoms. A psychologist, clinical social worker, or licensed counselor diagnoses and treats mental health conditions with psychotherapy. A psychiatrist can prescribe medication if needed.
PsA increases heart disease risk. A cardiologist specializes in diagnosing and treating heart conditions. They may order tests and prescribe treatments, such as lifestyle changes or medication, to protect your heart.
Effects Of Ankylosing Spondylitis On The Body And How To Treat It
Ankylosing spondylitis (AS) is a type of arthritis that can affect many parts of the body. Treatment can help slow the progression of the disease and manage the symptoms.
Ankylosing spondylitis (AS) causes inflammation in the joints of the spine, which can lead to severe, chronic pain. In advanced cases, AS can cause bones in the spine to fuse, leading to a loss of mobility.
Over time, the disease may affect other joints, including the ribs, neck, knees, and feet. In rare cases, people may have heart or lung complications due to AS.
Treatment can slow or halt the progression of the disease, and certain exercises can help people manage their symptoms, relieve pain, and avoid complications.
This article examines how AS affects the body over time, how to treat and manage these effects, and what the outlook is for people with this condition.
In the early stages, AS symptoms often affect only the spine and lower back. In males, AS primarily affects the sacroiliac joint, where the spine and pelvis join. In females, it often first affects the cervical or thoracic spine. The cervical spine consists of seven vertebrae in the neck, and the thoracic spine is the area from the bottom of the neck to the bottom of the ribs.
Over a longer period, stiffness and pain can spread throughout the spine and neck. This spread may occur over several months or years.
AS-related inflammation may also affect organs such as the eyes, heart, and lungs.
According to the Spondylitis Association of America, in its early stages, AS most commonly affects the spine, causing frequent pain and stiffness in the lower back.
The symptoms of AS in the early stages are due to joint inflammation — they are not related to any mechanical cause. They tend to come on gradually over several weeks or months. The symptoms are usually worse in the morning and after rest, but light exercise or a warm shower can often relieve pain and stiffness.
"Ankylosing" means "stiffening," and "spondylitis" means "spine inflammation." The combined term "ankylosing spondylitis" refers to spinal stiffness resulting from inflammation and the fusion of bones.
As the inflammation travels up the spine, it can affect a person's posture. If the spinal bones, called vertebrae, begin to fuse, the person may lose flexibility in their spine. This can result in decreased mobility and changes in posture.
The bones fuse because calcium deposits appear around the ligaments and the disks between the vertebrae. These deposits occur as a result of the bones healing from the inflammation. Spinal fusion leaves the vertebrae brittle and prone to fractures, and it can result in kyphosis, a forward curving of the spine.
Controlling inflammation early — by taking the appropriate medications and doing certain stretches and exercises — can help delay the progression of AS and stop it from spreading farther up the spine or to other parts of the body.
AS primarily affects the sacroiliac joint, but as the disease progresses, it can affect any joint in the body.
Symptoms in all affected joints include pain, stiffness, and swelling.
AS causes inflammation of the synovial membrane, which is the tissue that lines the inside of the joints. This joint inflammation is known as synovitis.
While symptoms of AS can appear in any joint, they are most common in the larger joints of the body.
Symptoms of AS may arise in the joints in the following areas:
AS affects the hip and shoulder joints in about one-third of people with the condition.
One hallmark of AS is enthesitis, which is inflammation in the places where ligaments attach to bones. The effects of enthesitis are particularly significant in the feet and can affect mobility. AS mainly affects two areas of the feet: the Achilles tendon and the base of the heel.
In about 15% of people with AS, the inflammation affects the temporomandibular joint, causing jaw pain and difficulty chewing.
Inflammation from AS can spread up the spine and affect the chest because the ribs are attached to the vertebrae. Here, it can cause chest pain and trouble breathing. When inflammation causes stiffness in the ribs, it is more difficult for the chest to expand when a person inhales.
The result is a feeling of air hunger or tightness in the chest. People may feel like their breaths are inadequate as their lungs struggle to expand in a tight rib cage.
If the disease progresses, the ribs may become fused to the spine, worsening these symptoms.
Practicing deep breathing exercises after a shower or using ice packs on the ribs can help. Learning how to do diaphragmatic breathing may also be beneficial.
Inflammation in the eyes, known as iritis or uveitis, is common in AS. About one-third of people with AS have eye inflammation at least once during the course of the disease.
People may experience the following eye-related symptoms:
Many people with AS experience inflammation in the bowel, which is associated with inflammatory bowel diseases such as Crohn's disease and ulcerative colitis.
As a result of the spinal involvement and subsequent neurological complications, AS can reduce a person's ability to control urination or bowel movements, leading to incontinence.
Heart and lung complications from AS are rare.
A person may experience an irregular heartbeat or an inflamed aorta, which is the main artery from the heart.
Some people with AS develop sleep apnea, which means that their breathing repeatedly stops during sleep.
In some cases, lung tissue may develop scarring, lesions, or cysts.
Some people may have a functional lung impairment, meaning that it can take longer for respiratory infections and colds to heal.
While there is no cure for AS, various treatments can slow or stop its progression. Treatment plans generally include regular medication and exercises.
Eating a varied and nutritious diet, using hot and cold packs to relieve pain, and avoiding smoking can benefit the overall management of AS and should be part of all treatment plans.
MedicationsDoctors often recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to manage AS-related inflammation. Pain relievers and local injections of corticosteroids are also options for symptom management.
Doctors may prescribe disease-modifying antirheumatic drugs (DMARDs) in severe AS cases and instances of peripheral disease involvement. These medications can reduce joint inflammation. Examples include:
Most people do not need surgery, but it is an option if the pain is severe or persistent or significantly limits the person's mobility or quality of life.
Read more about drug treatments for AS here.
Physical therapyPhysical therapy, such as stretching and mobility exercises, can help reduce back pain and stiffness due to AS. Experts recommend doing these exercises every day.
The Spondylitis Association of America recommends that AS exercise programs include the following four elements:
Learn about specific exercises for AS and their benefits.
Each person's experience with AS is unique. The severity and location of the symptoms and the disease progression vary widely among individuals. For example, according to a 2020 research review, men typically have more severe joint inflammation and damage, whereas women typically have higher disease activity and peripheral complications.
AS is a progressive disease. Without treatment, the symptoms may spread and worsen. Many people with untreated AS experience chronic pain and loss of flexibility, and these effects can lead to physical disability.
However, with treatment and lifestyle strategies, people can reach states of remission in which they have less disease activity and fewer physical limitations.
By working directly with a primary care doctor or a rheumatologist, people with AS can usually create a treatment plan that helps them manage AS. Once the plan is in place, following it carefully will help prevent the disease from progressing.
AS is a type of arthritis that primarily affects the spine and lower back. Over time, it can spread to other joints.
The inflammation that AS causes can also affect the organs, including the eyes, the bowel, and — in rare cases — the heart and lungs.
People with AS can prevent disease progression by taking medications as prescribed, doing a range of exercises, and maintaining certain lifestyle habits.
Ulcerative Colitis
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Colon Cancer
Although most patients with ulcerative colitis will not develop colon cancer, patients with ulcerative colitis are at a 2 to 5 fold increased risk of developing colon cancer compared to persons without ulcerative colitis. Researchers believe the increased risk of colon cancer is related to chronic inflammation in the colon. In order to detect colon cancer at an early stage, most patients with ulcerative colitis will need to undergo colonoscopies on a regular interval that is more frequent than for patients without ulcerative colitis. The risk of colon cancer may be even higher in individuals who have a condition of the liver called primary sclerosing cholangitis (PSC) or with family members who have had colon cancer. All patients with ulcerative colitis should discuss the timing and frequency of colonoscopy with their gastroenterologist.
Surgery
Most patients with ulcerative colitis will not require surgery. However, some patients may not respond to medications or have other severe symptoms that require removal of the colon. Removal of the colon is the closest thing to a "cure" for ulcerative colitis because unlike Crohn's disease, ulcerative colitis does not affect other parts of the digestive system and should not recur after complete removal of the colon. After removal of the colon, patients may require either an ostomy (bag) or reconstructive surgery, referred to as a "J-pouch" or ileal pouch-anal anastomosis (IPAA). The choice of these options is between the patient and the surgeon as each option has its' advantages and disadvantages.
Patients with ulcerative colitis may have symptoms in parts of their bodies outside of the digestive system.
Joints
There are forms of arthritis and back pain that are related to ulcerative colitis. Some of these conditions improve with medications for the digestive symptoms of ulcerative colitis. The use of over-the-counter pain medications such as ibuprofen, naproxen, and aspirin may increase the symptoms of ulcerative colitis. Patients with ulcerative colitis should speak with their gastroenterologist before using these medications.
Eyes
Some patients with ulcerative colitis develop inflammation in the eyes, called iritis or uveitis. Iritis may result in redness or eye pain and may fluctuate with the severity of the digestive symptoms of ulcerative colitis. Uveitis may result in severe eye pain and loss of vision. Patients with ulcerative colitis should see an eye doctor on a regular basis and report any changes in their vision to their doctor immediately.
Skin
There are two conditions related to ulcerative colitis, erythema nodosum and pyoderma gangrenosum. Erythema nodosum consists of painful red bumps under the skin that may develop when the ulcerative colitis flares; these lesions will often respond to the medication for ulcerative colitis. Pyoderma gangrenosum consists of skin ulcers that may form either with or without a flare of ulcerative colitis digestive symptoms.
Other Complications
Other complications of ulcerative colitis disease include kidney stones, a liver condition called primary sclerosing cholangitis (PSC), and malabsorption of vitamins and nutrients.
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