{"id":3079,"date":"2025-07-28T13:47:30","date_gmt":"2025-07-28T13:47:30","guid":{"rendered":"https:\/\/www.londoncataractcentre.co.uk\/blog\/?p=3079"},"modified":"2025-07-28T13:47:32","modified_gmt":"2025-07-28T13:47:32","slug":"psoriasis-cataract-surgery","status":"publish","type":"post","link":"https:\/\/www.londoncataractcentre.co.uk\/blog\/psoriasis-cataract-surgery\/","title":{"rendered":"Cataract Surgery with Psoriasis: What You Need to Know"},"content":{"rendered":"\n

Cataract surgery is usually straightforward \u2014 but when you have a chronic condition like psoriasis, things can get a little more nuanced. Many people think of psoriasis as just a skin condition. But in reality, it\u2019s a systemic inflammatory disorder, and that has implications for your eyes, especially if you’re heading into surgery. From immune-modulating medications to the risks of delayed healing or flare-ups, there\u2019s a bit more to consider.<\/p>\n\n\n\n

If you\u2019ve been told you have cataracts and you’re also living with psoriasis, you\u2019re not alone \u2014 and there\u2019s good news. Cataract surgery is still very doable. But your surgical team will likely adapt parts of your care plan to take into account your medications, skin condition, and overall immune health. Whether you’re using topical treatments or biologics, it\u2019s important to understand how your psoriasis could interact with the surgical process, and what steps can be taken to keep everything on track.<\/p>\n\n\n\n

Let\u2019s walk through what you need to know.<\/p>\n\n\n\n

Understanding Psoriasis as a Systemic Condition<\/strong><\/h2>\n\n\n\n

Psoriasis is more than what you see on the skin\u2019s surface. At its core, it\u2019s an autoimmune condition \u2014 which means your body\u2019s immune system mistakenly attacks healthy cells. This immune activity doesn’t stay limited to the skin; it can affect joints (as in psoriatic arthritis) and even internal organs. The eyes are not excluded from this list.<\/p>\n\n\n\n

This systemic inflammation means your eye structures, particularly the uvea (middle layer of the eye), can become inflamed too. This condition, known as uveitis, is more common in people with psoriasis than in the general population. Even if you\u2019ve never had eye symptoms before, your medical team may monitor you more closely for signs of ocular inflammation during cataract surgery preparation.<\/p>\n\n\n\n

And it\u2019s not just the immune system that matters \u2014 your skin health around the eyelids can be another concern. Psoriatic plaques on the eyelids or scalp can make sterilisation for surgery more delicate, and post-op healing requires careful hygiene.<\/p>\n\n\n\n

The Impact of Psoriasis Treatments on Cataract Surgery<\/strong><\/h2>\n\n\n\n
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If you\u2019re on systemic treatments like methotrexate, cyclosporine, or biologic agents (e.g. adalimumab, secukinumab), your immune system is being intentionally dampened to control flare-ups. This can be a double-edged sword. On one hand, it helps reduce systemic inflammation that could interfere with healing. On the other, it increases your susceptibility to infections \u2014 including eye infections post-surgery.<\/p>\n\n\n\n

Your ophthalmologist and dermatologist may coordinate on whether your medication should be paused or adjusted before the operation. This is especially relevant if you\u2019re receiving injections on a regular schedule. Some doctors recommend timing the surgery between doses when immune suppression is at its lowest. Others may feel it\u2019s safer to continue uninterrupted, depending on your overall stability.<\/p>\n\n\n\n

Topical treatments like steroid creams around the face or eye also play a role. Long-term steroid use \u2014 even topical \u2014 is associated with a higher risk of cataracts. Your surgeon may ask for a detailed history of how often you’ve used these medications, as it can influence lens opacification and risk of secondary complications.<\/p>\n\n\n\n

Managing Ocular Surface Inflammation in Psoriatic Patients<\/strong><\/h2>\n\n\n\n

The ocular surface \u2014 that delicate interface between your eye and the outside world \u2014 can be affected by psoriasis. Dry eye, blepharitis (eyelid inflammation), and meibomian gland dysfunction are all more common in people with psoriasis. These conditions may not sound serious, but they can affect how well your eye heals after surgery, how comfortable you feel, and even how well your vision recovers.<\/p>\n\n\n\n

Dryness can interfere with the accuracy of your pre-operative measurements (used to select your lens implant), and post-operative irritation can increase the risk of infection or delayed healing. Your eye surgeon may recommend pre-treatment for dry eye or lid inflammation weeks before your cataract operation \u2014 this could include lubricating drops, anti-inflammatory eye drops, or even short courses of oral antibiotics.<\/p>\n\n\n\n

In some cases, ocular surface management is so critical that surgery may be postponed until these issues are better controlled. It\u2019s not about being overly cautious \u2014 it\u2019s about giving you the best possible chance of a smooth recovery and crisp visual results.<\/p>\n\n\n\n

Psoriatic Arthritis and Cataract Surgery Planning<\/strong><\/h2>\n\n\n\n
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If you have psoriatic arthritis, your joints may already be limiting your mobility. This can become a consideration during surgery positioning. Cataract surgery requires you to lie flat and still for 10\u201320 minutes. If neck or back pain makes this difficult, adjustments can often be made \u2014 such as supporting your head with extra pillows or using a more reclined surgical chair setup.<\/p>\n\n\n\n

Your anaesthesia team should be made aware of any joint stiffness or medication use that could affect blood clotting, bleeding risk, or breathing patterns during light sedation. It\u2019s also worth discussing how to manage your arthritis medications around the time of surgery, especially if you\u2019re on NSAIDs or biologics that may impact healing or increase bleeding risk.<\/p>\n\n\n\n

What\u2019s often forgotten is that psoriatic arthritis can affect the small joints of the hands. If you’re planning to self-administer eye drops after surgery, make sure your grip and dexterity are up to the task \u2014 or arrange for help from someone at home during recovery.<\/p>\n\n\n\n

Addressing Flare-Ups Around the Eyes<\/strong><\/h2>\n\n\n\n

If you\u2019re experiencing a flare-up of psoriasis around your eyelids or eyebrows, your cataract surgery may need to be postponed. Open surgical wounds and inflamed skin do not mix well \u2014 the risk of infection or poor healing is just too high.<\/p>\n\n\n\n

But flare-ups can also be mild and manageable. If the affected area is not within the sterile field or can be protected during surgery, your surgeon might go ahead with extra precautions. They may work alongside your dermatologist to bring the flare under control first, often using non-steroidal anti-inflammatory topicals or UVB therapy.<\/p>\n\n\n\n

After surgery, even a mild flare around the eye can make you more prone to rubbing \u2014 something you must avoid during cataract recovery. Keeping your hands clean and your skin hydrated (with doctor-approved emollients) will reduce this risk significantly.<\/p>\n\n\n\n

Special Considerations for Biologic Therapy<\/strong><\/h2>\n\n\n\n

Biologic therapies have revolutionised how moderate to severe psoriasis is treated. However, they come with complex implications during surgery. These drugs \u2014 such as infliximab, ustekinumab, or ixekizumab \u2014 selectively target parts of the immune system like TNF-alpha or IL-17, which play a role in inflammation. While this can keep psoriasis at bay, it also means your immune defences are not fully alert.<\/p>\n\n\n\n

Your surgeon may recommend additional antibiotic prophylaxis or delay the surgery depending on your dosing schedule. There\u2019s also a small concern about poor wound healing with biologics, though this isn\u2019t proven in every case. What\u2019s clear is that your dermatologist and eye surgeon need to coordinate, ideally with your GP too, to time your biologic injections strategically around the surgery window.<\/p>\n\n\n\n

You should never stop or adjust these medications on your own \u2014 the risk of a psoriasis flare could be worse than the surgical concern itself.<\/p>\n\n\n\n

Cataract Surgery Outcomes in Patients with Psoriasis<\/strong><\/h2>\n\n\n\n
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So, how do patients with psoriasis actually do after cataract surgery? Generally, outcomes are very positive \u2014 but recovery might require a little more monitoring. Visual acuity tends to improve significantly, provided there are no major complications from inflammation or infection.<\/p>\n\n\n\n

One known risk is the development of posterior capsule opacification (PCO), a common side effect where the lens capsule becomes cloudy months or years after surgery. Some studies suggest inflammation-prone eyes \u2014 like those in autoimmune diseases \u2014 might develop PCO sooner. Luckily, this is easily treatable with a quick laser procedure called YAG capsulotomy.<\/p>\n\n\n\n

Your risk of dry eye may persist after surgery, especially if your psoriasis affects the lids or conjunctiva. But these symptoms can be managed long term with drops, heat therapy, or prescription anti-inflammatories.<\/p>\n\n\n\n

Lifestyle and Recovery Tips Tailored for Psoriatic Patients<\/strong><\/h2>\n\n\n\n

After surgery, you\u2019ll need to keep your eyes protected and avoid strenuous activities. But when you have psoriasis, there are a few extra tweaks you can make. Firstly, ensure you\u2019re not exposing your skin to harsh chemicals or scented cleansers around the eyes \u2014 even if they\u2019ve been fine on your body, the skin near your eyes is more delicate post-surgery.<\/p>\n\n\n\n

Second, if you have joint stiffness, consider using an eye drop aid \u2014 small plastic devices that make applying drops easier. They\u2019re cheap and can help you stay consistent with your medications during the crucial early recovery phase.<\/p>\n\n\n\n

Finally, flare prevention is key. Stress, poor sleep, and medication disruptions can all make your psoriasis worse \u2014 and this might, in turn, affect your eye health too. So during your recovery, prioritise rest, hydration, gentle skincare, and regular follow-ups.<\/p>\n\n\n\n

FAQ: Cataract Surgery and Psoriasis<\/strong><\/h2>\n\n\n\n
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  1. Can I still have cataract surgery if I have moderate to severe psoriasis?<\/strong>
    Yes, cataract surgery is still an option even if your psoriasis is severe or widespread. However, it does require more careful planning. Your ophthalmologist will take into account your current treatment plan, any history of flare-ups near the eyes, and whether you have any signs of active inflammation. In most cases, the surgery can proceed safely with some adjustments to ensure healing is smooth and complications are minimised.<\/li>\n\n\n\n
  2. Will my psoriasis treatment affect the outcome of surgery?<\/strong>
    Your psoriasis treatment can influence your surgical experience, particularly if you’re on systemic medications like biologics or immunosuppressants. These drugs help control inflammation but can also slow healing and increase the risk of infections. Your surgical team may adjust the timing of your operation to align with your treatment cycle, and they might take additional steps such as prescribing antibiotics or anti-inflammatory drops to help your eyes recover properly.<\/li>\n\n\n\n
  3. Do I need to stop my biologic medication before cataract surgery?<\/strong>
    Stopping biologic medication before cataract surgery is not always necessary, but it does depend on your individual case. Some surgeons prefer to operate in between biologic doses when your immune system is more responsive, while others may continue your schedule uninterrupted to avoid a psoriasis flare. This decision should be made by your ophthalmologist in consultation with your dermatologist or rheumatologist, and it must be carefully balanced to maintain your overall health.<\/li>\n\n\n\n
  4. Can psoriasis affect the inside of the eye?<\/strong>
    Yes, while psoriasis is mainly known for affecting the skin, it can also cause internal inflammation within the eye, especially in the form of uveitis. This is more likely if you also have psoriatic arthritis. Uveitis can cause redness, pain, light sensitivity, and blurred vision \u2014 all of which may complicate cataract surgery. If you’ve experienced any of these symptoms in the past, it’s important to mention them during your pre-surgical assessments so that your team can monitor and manage any flare-ups effectively.<\/li>\n\n\n\n
  5. What happens if I have psoriatic plaques near my eyes?<\/strong>
    If you have active plaques or inflamed skin around your eyelids or face, your surgeon may recommend delaying surgery until the area is under control. This is because cracked or broken skin near the surgical site increases the risk of infection. In less severe cases, your dermatologist may suggest treatments to reduce inflammation quickly, allowing the surgery to go ahead safely. The goal is to ensure a clean, stable environment around the eye so that your recovery is not compromised.<\/li>\n\n\n\n
  6. Are there extra risks of infection after surgery if I have psoriasis?<\/strong>
    Yes, there can be a slightly higher risk of infection, especially if your immune system is suppressed by medications like methotrexate or biologics. The eye is generally good at healing, but immune-modifying drugs may reduce your natural defences. Your surgeon may prescribe prophylactic antibiotics and monitor you closely in the days and weeks following surgery. With proper planning and hygiene, the risk can be minimised significantly, and the vast majority of patients recover without complications.<\/li>\n\n\n\n
  7. How should I care for my skin around the eyes after surgery?<\/strong>
    After cataract surgery, it\u2019s essential to avoid using harsh products or heavy moisturisers near your eyes \u2014 even if they\u2019ve helped your psoriasis elsewhere. Stick to mild, fragrance-free emollients approved by your doctor and avoid rubbing or scratching the area. Your eyelids and the skin around your eyes will be more sensitive during recovery, so keeping things clean and simple will help reduce irritation and lower the risk of complications like infection or delayed healing.<\/li>\n\n\n\n
  8. Will dry eye symptoms get worse after cataract surgery?<\/strong>
    Dry eyes are a common issue after cataract surgery, and people with psoriasis are already at higher risk of this problem due to eyelid inflammation or meibomian gland dysfunction. If you\u2019ve experienced dry eye symptoms before, let your surgeon know \u2014 they may recommend pre-treatment with lubricants or anti-inflammatory drops in advance. Managing this properly helps improve comfort after surgery and ensures that your vision recovers without unnecessary irritation or blurry patches.<\/li>\n\n\n\n
  9. Can psoriatic arthritis affect the surgery?<\/strong>
    Psoriatic arthritis can make lying flat or keeping still during surgery more challenging, especially if your spine, neck, or joints are affected. It can also impact how well you\u2019re able to apply eye drops afterwards if your hands or wrists are stiff or painful. Your team can make accommodations such as adjusting your position on the surgical table or recommending drop aids for home use. It’s important to let them know in advance about any joint-related issues that could affect your comfort or recovery.<\/li>\n\n\n\n
  10. What should I tell my eye surgeon before the operation?<\/strong>
    Be honest and detailed when talking to your eye surgeon about your psoriasis. Tell them what medications you use \u2014 both systemic and topical \u2014 and whether you\u2019ve ever had a flare near your eyes. Let them know if you\u2019ve experienced dry eye, joint pain, or inflammation inside the eye. This information helps your surgeon personalise your care, anticipate any potential issues, and coordinate with your dermatologist or rheumatologist if adjustments to your treatment are needed before or after surgery.<\/li>\n<\/ol>\n\n\n\n

    Final Thoughts<\/strong><\/h2>\n\n\n\n

    Cataract surgery with psoriasis might sound like a complicated intersection of two very different conditions, but it doesn\u2019t have to be overwhelming. With the right coordination between your ophthalmologist, dermatologist, and GP \u2014 and a little extra care with your eyes and skin \u2014 there\u2019s every reason to expect excellent results. The key is planning ahead, knowing your risks, and not being afraid to speak up about flare-ups or medication side effects.<\/p>\n\n\n\n

    If you\u2019re in the UK and looking for experienced care that understands complex conditions like psoriasis, the London Cataract Centre offers consultant-led cataract surgery<\/a> with full pre-operative assessment and tailored recovery planning. You\u2019re not just a pair of eyes \u2014 you\u2019re a whole person. And your care should reflect that.<\/p>\n\n\n\n

    References<\/strong><\/h2>\n\n\n\n
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    1. Wu, D., Cai, R., Pang, Y., Ma, J., Chen, B. et\u202fal., 2025. Bidirectional association between uveitis and psoriasis: a systematic review and meta\u2011analysis<\/em>. Clinical and Experimental Medicine, 25, Article\u00a0161. Available at: https:\/\/link.springer.com\/article\/10.1007\/s10238-025-01693-0<\/a><\/li>\n\n\n\n
    2. Mokbel, R., et\u202fal., 2025. Ocular complications in psoriatic patients: a systematic review and meta\u2011analysis<\/em>. Journal of Ophthalmic Inflammation and Infection, published April 2025. Available at: https:\/\/joii-journal.springeropen.com\/articles\/10.1186\/s12348-025-00486-6<\/a><\/li>\n\n\n\n
    3. Fotiadou, C., Lazaridou, E., Sotiriou, E., Ioannides, D. and Vakirlis, E., 2025. Ocular manifestations of psoriasis: a comprehensive review<\/em>. Dermatologic Therapy. Available at: https:\/\/www.tandfonline.com\/doi\/full\/10.1080\/09273948.2025.2459710<\/a><\/li>\n\n\n\n
    4. ResearchGate team, 2021. Risk of incident cataract in patients with psoriasis: a population\u2011based cohort study<\/em>. ResearchGate (based on Chang Gung Research Database). Available at: https:\/\/www.researchgate.net\/publication\/356778404_Risk_of_incident_cataract_in_patients_with_psoriasis_A_population-based_cohort_study<\/a><\/li>\n\n\n\n
    5. Elm, J., et\u202fal., 2023. Psoriasis beyond the skin: Ophthalmological changes<\/em>. International Journal of Dermatology and Venereology, review article. Available at: https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC8311223\/<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

      Cataract surgery is usually straightforward \u2014 but when you have a chronic condition like psoriasis, things can get a little more nuanced. Many people think of psoriasis as just a skin condition. But in reality, it\u2019s a systemic inflammatory disorder, and that has implications for your eyes, especially if you’re heading into surgery. From immune-modulating […]<\/p>\n","protected":false},"author":2,"featured_media":3086,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"","_et_gb_content_width":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-3079","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t