Patients with Psoriasis at Increased Risk for Conjunctivitis, Other Ocular Conditions

Individuals with psoriasis are at a greater risk for developing ocular conditions such as conjunctivitis, conjunctival hyperemia, dry eye, and meibomian gland dysfunction, according to recent findings, although additional analyses may be warranted to improve understand of the related mechanisms and help address management strategies.1

This study was led by Adriano Cypriano Faneli, from the Bahiana School of Public Health and Medicine in Salvador, Brazil. Faneli and the investigative team set out to look into the prevalence of ocular findings among those living with psoriasis, as well as to compare the odds of development of ocular conditions between psoriatic and control populations.

Faneli et al. highlighted an approximate 10% prevalence of ocular symptoms among those with psoriasis, noting previous research that has pointed to the prevalence and relative likelihood of various ocular findings among such patients. However, the investigators added that the overall prevalence and odds ratios of such ocular conditions within all data regarding psoriatic patients had not previously been described.2

“Therefore, this systematic review and meta-analysis were conducted to assess the prevalence and relative likelihood of ocular findings in the psoriatic population and better elucidate the association between ophthalmological diseases and psoriasis,” Faneli and colleagues wrote.1

Ocular Findings in Patients with Psoriasis

The investigative team began their search of databases for studies evaluating ocular conditions among those with psoriatic diseases, with the assessment lasting from May - June 2024. They implemented a varity of search terms related to ocular conditions and forms of psoriasis, looking at the Embase, PubMed, Cochrane, and Web of Science databases.

The team conducted searches using references from all included studies, from meta-analyses, and from prior systematic reviews, looking at any other research on the topics covered. An independently extraction by 2 investigators was conducted, with a predefined criteria for searches and quality assessment being taken into account.

Then, the investigators would look at the full articles of publications deemed to be eligible. Ocular condition prevalence among those with psoriatic disease was predefined by the team as their study's primary outcome.

Using a set of criteria, the investigators would only include the following type of research in their meta-analysis: Case-control, cross-sectional, case series, cohort studies, or case studies. An assessment of quality was carried out by the 2 investigators who extracted the data.

The research team carried out a single-arm analysis with the aim of estimating the prevalence of different ocular conditions in individuals who live with psoriasis. The team also made comparisons in a secondary analysis between the prevalence of such conditions in those with uveitis to those without uveitis or with a history of uveitis.

A lack of sufficient information for statistical analysis of all of the evaluated outcomes in the team's collection of data was acknolwedged. Bias risk was also assessed via the Newcastle-Ottawa Scale, and the investigators looked at heterogeneity in the data through the use of Cochran’s Q-test and I² statistics, applying a random-effects model where they noted substantial heterogeneity.

There were a total of 131,687 individuals included in the final analysis, with 30 studies. Among these individuals, 13,788 were in the psoriasis group and 117,899 were considered controls.

Among patients with psoriatic disease, the relative likelihood of ocular findings compared to controls was shown to have risen in conjunctivitis (OR = 4.63; 95% CI: 1.42–15.08), conjunctival hyperemia (OR = 7.38; 95% CI: 2.47–22.04), meibomian gland dysfunction (OR = 7.13; 95% CI: 2.14–23.72), and dry eye (OR = 3.47; 95% CI: 2.06–5.83).1

Cataracts, blepharitis, episcleritis, glaucoma, pterygium, pinguecula, and uveitis rates were all shown not to have differed substantially between both the psoriatic and control cohorts.

“In conclusion, this systematic review and meta-analysis demonstrate the prevalence of 25 ocular diseases in psoriatic patients,” they wrote. “Also, it shows that psoriasis patients have an increased relative likelihood of developing conjunctival hyperemia, conjunctivitis, dry eye, and meibomian gland dysfunction.”1

References

1. Faneli, A.C., Amaral, D.C., Menezes, I.R. et al. Ocular complications in psoriatic patients: a systematic review and meta-analysis. J Ophthal Inflamm Infect 15, 29 (2025). https://doi.org/10.1186/s12348-025-00486-6.

2. Motlagh M, Fortenbach C, Maibach HI, Modjtahedi BS (2022) Identifying and treating ocular manifestations in psoriasis. Am J Clin Dermatol 23:51–60. https://doi.org/10.1007/s40257-021-00648-x.