Purpose of review This review aims to summarize current knowledge on ocular surface side effects associated with novel systemic therapies for atopic dermatitis (AD) and psoriasis. Recent findings Interleukin inhibiting monoclonal antibodies such as dupilumab and tralokinumab, along with small molecule JAK–STAT inhibitors such as upadacitinib and abrocitibib, have revolutionized the treatment of AD and psoriasis. Despite their effectiveness in disease control, these agents have been increasingly associated with ocular adverse events, particularly conjunctivitis. While dupilumab-induced conjunctivitis is the most documented, emerging data highlights variable ocular safety profiles across different agents. Early recognition and grading of ocular inflammation through clinical examination allows for effective management with topical anti-inflammatory treatment. In severe or refractory cases, switching or discontinuing therapy may be necessary. Summary With the expanding use of novel systemic dermatologic therapies, ocular surface complications have become an important concern. Multidisciplinary collaboration and increased awareness are vital to prevent vision-threatening outcomes. Ongoing research is needed to elucidate pathophysiology and optimize therapeutic approaches that balance effective skin disease control with ocular health.