Psoriatic Arthritis and the eyes

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Uveitis

Uveitis means inflammation of the uvea. This can affect the iris (iritis), ciliary body (cyclitis) or the choroid (choroiditis). Symptoms depend on whether all or just part of the uvea is affected, but may include:

  • dull, aching pain in the eye
  • redness
  • risk is higher if B27+?? so common in spondylitis sub groups
  • it can occur whether arthritis currently active or not
  • blurred or misty vision
  • a muddy appearance to the coloured iris in the affected eye
  • a pupil that may be smaller than on the other side and irregular in outline.

Symptoms can affect one or both eyes. Inflammation is thought to result from the immune system attacking the cells of the uvea. Treatment of uveitis is urgent to stop the inflamed iris from sticking to the lens behind. This would cause permanent damage to the eye and can also trigger glaucoma (rise in fluid pressure in the eye due to blocked drainage channels). Uveitis often returns from time to time.

Note: Children with psoriatic arthritis should have regular screening tests for uveitis as they may not develop symptoms until their eyesight has been damaged and irreversible visual impairment takes place.

Treatment

Inflammation is damped down with eye-drops containing corticosteroid drugs. In severe cases, you may also need to take steroid tablets by mouth to boost the effect of the drops. Eye-drops that relax the iris and ciliary body are also used. These make the pupil dilate and ensure that an inflamed iris does not stick to the eye lens (posterior synechia). The inflam mation is monitored by regular examination of the eye using a slit-lamp. If steroid eye drops are used for prolonged periods, the fluid pressure in the eye will also need to be checked regularly. This is because long-term use of steroid drops can cause a form of glaucoma.

Useful contact
The Royal College of Ophthalmologists (eye specialists):. Can provide a list of practising ophthalmologists. www.rcophth.ac.uk

Other diseases of the eye include Blepharitis, Cataracts, Conjunctivitis, Cysts, Detatched Retinas, Glaucoma, Keratitis and Styes.