Clinical profile, ocular morbidity and visual loss in psoriasis: Experience in a multispeciality hospital

To analyse various ocular abnormalities and visual morbidity in patients with psoriasis and to detect ocular complications following psoriasis treatment. A prospective observational study was conducted among 120 psoriasis patients. All patients underwent slit lamp examination, indirect ophthalmoscopy, Schirmer’s test, Tear breakup time and Rose Bengal staining and ancillary investigations when required. Among 120 patients, the prevalence of ocular manifestation was 57%, of whom 22% were symptomatic. Ocular features were most common in scalp psoriasis and pustular psoriasis. Disease duration was not found to have any impact on the severity of ocular manifestation. The most common ophthalmic feature was ocular surface disorder (46%), followed by cataract (30%), meibomitis (17%) and blepharitis in 16%. Correlation between tests was calculated using kappa coefficient and statistical significance was found in the pattern of conjunctival staining with a p value of 0.02. Out of 9 patients with psoriatic arthritis, 3% showed signs of chronic uveitis. Steroid induced glaucoma was seen in 27% and ocular hypertension in 21%. Corticosteroid used in systemic management frequently caused visual morbidity. Ocular signs and symptoms in psoriasis may be subtle and overlooked, hence complete ophthalmic examination is recommended for early detection of ocular abnormalities. Early treatment for dry eye is important to prevent irreversible ocular surface changes. Regular monitoring prevents steroid induced cataract and steroid induced glaucoma. As multisystem involvement is seen in psoriasis, a multidisciplinary approach reduces ocular morbidity.