Can Pemphigus Vulgaris (an autoimmune disease) cause eye irritation, and what is the eye drop treatment?

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From the Guidelines

Pemphigus vulgaris can indeed cause eye irritation, and the recommended treatment includes topical corticosteroid eye drops, such as loteprednol etabonate, as indicated in the study 1. The eye irritation in pemphigus vulgaris typically manifests as conjunctivitis or erosions on the conjunctiva.

  • For mild cases, topical antihistamines or mast cell stabilizers, such as azelastine or ketotifen, may be used to alleviate symptoms, as mentioned in the study 1.
  • However, for more severe cases, topical corticosteroid eye drops, such as loteprednol etabonate, are the preferred treatment, applied 4-6 times daily during active inflammation, as indicated in the study 1.
  • Preservative-free artificial tears can also be used frequently throughout the day to provide lubrication and comfort.
  • Patients should avoid rubbing their eyes to prevent further damage to the conjunctival surface.
  • If there are signs of secondary bacterial infection, antibiotic eye drops like moxifloxacin or tobramycin may be prescribed.
  • It's essential to note that eye involvement in pemphigus vulgaris requires concurrent systemic therapy to control the underlying autoimmune disease, and an ophthalmologist should be consulted for proper evaluation and management of ocular manifestations. The study 1 provides information on the treatment of dry eye syndrome, which may be relevant in some cases of pemphigus vulgaris, but the primary focus should be on controlling the autoimmune response and inflammation in the ocular tissues. The most recent study 1 from 2024 provides guidance on the treatment of severe dry eye, but the study 1 from 2008 remains the most relevant for the treatment of ocular allergy symptoms, including those associated with pemphigus vulgaris.

From the Research

Pemphigus Vulgaris and Eye Irritation

  • Pemphigus Vulgaris (PV) is an autoimmune disease that can cause eye irritation, as reported in studies 2, 3.
  • Ocular involvement in PV is seen in up to 16% of patients, with conjunctivitis being the most common clinical presentation 2, 3.
  • The most commonly reported symptoms of ocular involvement in PV are eye irritation and redness, affecting 76.5% of patients 3.

Eye Drop Treatment for Pemphigus Vulgaris

  • There is no specific mention of eye drop treatment for PV in the provided studies.
  • However, the use of steroid-sparing agents and cytokine blockers has been reported to help control the disease, including ocular involvement 2.
  • Conjunctivitis, a common type of ocular involvement in PV, may be treated with topical corticosteroids or other anti-inflammatory agents, but this is not explicitly stated in the provided studies.

Ocular Involvement in Pemphigus Vulgaris

  • Ocular involvement in PV can occur independently of disease activity and extension 3.
  • Conjunctivitis is the most common type of ocular involvement, followed by erosion of the palpebral conjunctiva 3.
  • Recalcitrant conjunctivitis with conjunctival blisters should warrant a workup for systemic PV 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Ocular involvement in pemphigus vulgaris.

The Journal of dermatology, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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