In a large retrospective cohort study using the TriNetX Global Collaborative Network, biologic therapy in patients with psoriasis was associated with a lower risk of multiple ocular surface and corneal diseases compared with nonbiologic systemic treatments, with the strongest associations observed for dry eye disease, conjunctivitis, and keratitis; these effects were evident from 6 months and persisted up to 10 years, while no consistent reduction was seen for retinal or vitreous diseases.