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Living with Psoriatic Arthritis (PsA)

Eye Problems?

I have a troubling issue where I wake up with blood shot eyes and they itch. First I chalked it up to allergies which makes sense but today my wife just brought my attention to say my eyes are blood shot. I did not mention to her my previous ideas about itchy red eyes. So today my eyes are super itchy and red and I am wondering if something more is amiss. I am taking allergy medicines already and I just weaned myself off prednisone going on a week now. Anyone have any eye issues that relates to psa? I read some signs of eye problems and the only thing I have in common is bloodshot eyes that are itchy and a bit of light sensitivity to the canned lights in my house. Anyone have some info.? I suppose it could be allergies that my medicine is not addressing but I do not know. At what point should it be looked into?

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Have similar eye problems and have been told to see An eye doctor, rheumy said cosentix had eye issues as a possibile side effect but had these issues before diagnosis. Have read up on eye issues connected to psa potentially so we should go for screenings regards

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Thanks, for the reply. I found some stuff through search here and checking it out.

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With PsA, all eye issues should be checked out pretty much as they occur. Start with your GP or optician and work it from there. I would never just ‘sit’ with on eye problems given I’ve PsA.

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I do a lot of maintenance on my eyes, heated pads, Restasis drops, topical antibiotic ointment in my eyes and hypocloride spray on my eyelids, I also use a mask when I sleep to keep the eyes hydrated.
I think Restasis is a good medication for preventing inflammation of the eyes.

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Given you’ve just weaned yourself off prednisone, it seems quite possible that it’s one of the many extra-articular manifestations of PsA that can be a real pain in the eye.

There’s lots of innocuous things (or at least not much worse than really annoying) that it could be, but occasionally with PsA and/or our meds, it can be something serious, so it needs to be checked by an optometrist ASAP. They can exclude the more serious things (like Uveitis, which can’t really be assessed except by an eye doctor), and they should be familiar with what it is.

In my case, when this first happened, for example, it was blepharitis, but when I had it recur but with sharp eye pain six months later, it was actually an acute infection that needed antibiotic treatment. Nowadays, thankfully, my biologics take care of the inflammation that I used to get with chronic recurring blepharitis (one of the uncomfortable, but not serious issues), but when things weren’t working around a year ago, I noticed some eye pain and light sensitivity after a couple of days of redness, so I was in the optometrist ASAP to double-check.

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The pressure and pain got worst on through the night. I decided to take one prednisone and that seemed to help. I woke up with itchy bloodshot eyes so after my experiment with prednisone giving some relief I took my normal dosage 15mg and I seem to be responding to it with less symptoms. No officially a scientific method but it has helped enough to convince me to report it. I have a doctors appointment Monday that I previously scheduled. I have so much to report that I must prioritize what to report and then I make a list…

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@Poo_therapy—thanks, that was what I was thinking.

@Jon_sparky—thanks, I have used eye lubricant to no avail. I was reading about cold compress just last night. Is Restasis usually prescribed by doctor?

@Jen75—thanks, that is the thought that was running through my mind. Especially since taking prednisone and it seemed to help. Still itchy but less so and the bloodshot eyes are not as bad looking. I will be making an eye appointment after my GP. Before, I took prednisone my eye itchiness got worse with pain and pressure occurring. The big question going through my mind is whether my biologic Taltz is working or helping at all to some degree. I guess I need to figure out exactly what is occurring and then see about the need to change biologics to a TNF inhibitor.

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The hot compress clears the oil ducts in the eyelids, it is followed by gentle massage of the lower lids. Yes, Restasis is a Rx.

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Restasis is for controlling inflammation besides lubrication.

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Thanks Jon_sparky, will check it out. Dr. appointment today.

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Good luck!

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Hi @Woodworm! Any updates from the eye doctor?

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Thanks Jon_sparky and Stoney. My appointment is tomorrow for eye doctor. My GP indicated I was onto something with the uveitis and my recent gut trouble along with other symptom connections to psa. So I am getting tests done tomorrow and will go from there. It is a good thing I have prednisone on hand for flares and other things to help some what.

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I had Uveitis related to PSA. Light sensitivity was awful! It can cause blindness…better to be safe than sorry…see an eye doc.
The biologics are now covering it!

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Well, I went to the eye doc. and had an exam. She said as far as inflammation that she did not see anything alarming. She mentioned that on top of the eye I had dry spots in both and that was probably causing my discomfort. I have never had eye pressure, itchiness, and pain like that before. Anyway, I am taking a prednisone/antiobiotic solution along with an oral antibiotic. Hopefully, that will be the end of this weird thing. So the good news is there was no obvious big inflammation event but it does leave me wondering why in the world I had those symptoms for a little dry eye… I plan on keeping my dry eyes on it… heh

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Hey y’all,

So I do have PSA but I am also an eye doctor. The most common ocular manifestation for PSA is something called an iritis. With any pain or light sensitivity the eyes should be evaluated by a good optometrist to check for any ocular inflammation that may be causing the symptoms. Definitely get checked out sooner rather than later so appropriate therapy/eye drops can be prescribed accordingly.
There are other eye issues that may occur from long term use of prednisone. If anyone is on it make sure to see your optometrist and get your eye pressure checked.
I hope this helps!

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I was told that I have dry eyes from rheumatologist meds. Eye doctor tried me on xiidra which helped but was $600 a month and wasn’t much improvement over otc drops for the price. Eye dr. Recommended Systane and it helps a lot. You should ask to get screened for Schogrens another auto immune disease.

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I’m glad that it wasn’t anything extreme. You did mention that you had started back up on prednisone on your own? That’s important information.

If you have dry spots, it’s something that can be treated /managed. But you prob should be talking about getting checked more frequently, getting testing done for dry eye, etc. You prob should be tested for Sjogrens as well, but the diagnosis isn’t critical. It’s more critical to stay on top of the symptoms so that you minimize the risk of damaging your eyes. And yes, dry eye can hurt.

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I’ve had eye problems for years. Although I was only diagnosed a year ago, I’ve been dealing with psoriasis and PsA symptoms for many years- just took a while to get to a Rheumatologist.

I’ve been dealing with Blepheritis for a long time. Frequent infections caused by having too many skin cells around my eyes. These slough off causing irritation and ultimately infections. Treatment was scrubbing my eyelids and topical Gels. This is related to psoriasis.

The past year my eyes were almost constantly and severely red and irritated. Over that time I was on Humira, Stelara, and now Enbril which finally seems to be making a significant difference. At doc’s referral, saw an opthomologist who ruled out Uveitis (yay!). He suggested OTC drops for dryness. Didn’t help. Went back to Optometrist and was told I have damage from dry eyes (my vision was affected by this time and the pain was overwhelming). He put in contacts he called band-aids for several days. These prevented further damage to cornea from dry eyelids. He then prescribed Ristasis, which my insurance didn’t cover, so I’ve been using Xiidra instead which also works. Mentioned the eye dryness at Rheumatologist last visit and she also put me on oral pilocarpine which helps dry mouth and eyes.

I still scrub eyelids, massage lids, and use heat. It’s somewhat improved and for the first time in a couple years my eyes aren’t completely red. I still really have to make an effort to take a lot of eye breaks while working at my computer- which is most of my time.

Cosentyx did seem to take it to the major problem phase. Can’t say whether the Enbril is helping since I’m on all the other eye stuff.

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