How Does Atopic Dermatitis Affect the Eyes?

Atopic dermatitis is a type of eczema that causes dry, scaly, itchy patches of skin. Atopic dermatitis usually begins in infancy or early childhood, although it may continue or begin in adults. Some people with atopic dermatitis experience symptoms around their eyes.

What eczema symptoms occur around the eyes?

Eye eczema symptoms:

• Red rash or weepy skin around the eyes
• Itching around the eyes
• Eye watering
• Inflammation of the eyelid (blepharitis)
• Inflammation or infection of the eye (conjunctivitis)¹

With long-term chronic atopic dermatitis, eye symptoms may include:

• Thickening of the skin (lichenification) around the eye
• Changes in skin color around the eye (hyperpigmentation or hypopigmentation)
• Atopic cataracts¹

In addition, spontaneous retinal detachment is more common in people with atopic dermatitis than in the general population.¹

Blepharitis

Blepharitis is a term that means inflammation of the eyelids. Eyes may feel gritty or as though there is something in them. The eyes may be red, dry, and itchy, and the eyelids may appear swollen. Treatment may include topical antibiotics, oral antibiotics, or corticosteroids.²

Conjunctivitis

Conjunctivitis is inflammation of the eye that can be caused by an infection or an allergy, and it is commonly referred to as “pink eye.” Conjunctivitis may be caused by a bacteria or viral infection, and symptoms include redness of the eye, discharge or crusting of the eyelashes, itching, or burning. Treatment includes topical antimicrobials, oral antibiotics, or ophthalmic antibiotics.³

Atopic keratoconjunctivitis

Rarely, people with atopic dermatitis develop atopic keratoconjunctivitis (AKC), which is a potentially serious condition that can lead to blindness if not treated. AKC is more common in men than in women and usually occurs in people aged 30-50 years. Symptoms include itching, watery or teary eyes, ropy discharge, burning, sensitivity to light (photophobia), and/or decreased vision. Treatment for AKC includes mast cell stabilizers, antihistamines, steroids, and other immunosuppressive therapies. Some people with AKC may require surgery to reduce vision damage.⁴

Cataracts

Cataracts are a condition in which the lens of the eye becomes progressively opaque, causing blurred vision. Cataracts are estimated to occur in up to 25% of people with atopic dermatitis. In people with atopic dermatitis, the cataracts are usually bilateral (occurring in both eyes), and they typically occur in people in their 20’s or 30’s. Long-term use of corticosteroids has been associated with the development of cataracts, although corticosteroid-related cataracts do not commonly develop in children. Treatment for cataracts may involve surgical correction if there is significant vision impairment.^5,6

Retinal detachment

Retinal detachment affects the retina, the layer of tissue inside the eye that is sensitive to light and relays visual information through the optic nerve to the brain. When the retina detaches, it is pulled from its normal position. Without timely treatment, retinal detachment can cause permanent vision loss. One of the symptoms of retinal detachment is a sudden or gradual increase in floaters, the specks that drift around in the visual field.

Other symptoms of retinal detachment

Other symptoms include light flashes in the eye or an appearance of a curtain over the field of vision. Retinal detachment is considered a medical emergency and requires immediate attention by an eye care professional. Treatment may involve laser surgery or other surgery on the eye. With proper treatment, most people can be successfully treated.⁷