Ocular Comorbidities in Psoriasis: A Retrospective Study on Dry Eye Syndrome, Keratoconus, and Cataract Development

Psoriasis is a chronic, immune-mediated inflammatory condition primarily involving the skin but increasingly recognized to affect multiple organ systems. Emerging evidence has drawn attention to its potential association with ophthalmic comorbidities, notably dry eye syndrome (DES), keratoconus, and cataract. To determine the prevalence of DES, keratoconus, and cataract in individuals with moderate-to-severe psoriasis compared with matched healthy controls. A retrospective case-control study was conducted involving the review of medical records from 150 patients with psoriasis and 150 age- and sex-matched control subjects. Ophthalmic diagnoses were ascertained using ICD-10 coding and clinical documentation. Multivariable logistic regression was employed to evaluate the independent association between psoriasis and ocular conditions. The prevalence of keratoconus and DES was significantly higher in the psoriasis cohort than in controls (10.0% vs. 2.7%, p = 0.0178; 18.0% vs. 8.7%, p = 0.0272, respectively). Although cataract was more frequent among psoriasis patients (4.0% vs. 0.7%), the difference did not reach statistical significance (p = 0.1261). Psoriasis was independently associated with keratoconus (OR 4.03; 95% CI, 1.3-12.5) and DES (OR 2.31; 95% CI, 1.14-4.68). Subgroup analysis revealed a notably higher prevalence of keratoconus in female patients with psoriasis (p = 0.0159). These findings suggest that psoriasis may be associated with an increased likelihood of specific ocular conditions, particularly keratoconus and DES. The sex-related disparity observed in keratoconus prevalence warrants further investigation into possible hormonal factors, including the potential role of estrogen-mediated corneal changes. Routine ophthalmological evaluation could be considered as part of comprehensive care in patients with psoriasis.