How Eczema Affects the Eyes

Atopic dermatitis (eczema) can impact areas of the body beyond the skin. It can also affect the eyes, lips, ears, and more. Eczema and its symptoms can directly affect the eyes in a few ways. Eczema and some of its treatment options may also increase the risk of developing other eye issues later on.^1-5

Eye-related eczema symptoms

Eczema of the skin around the eyes (eyelid dermatitis) is common. In some people, it is the only area of the body that has symptoms. Just like with other areas, repeated scratching or rubbing can lead to patches of thickened skin. This is called lichenification.^1-4

People with eczema may also have chronic red or itchy eyes. This may be directly related to eczema, or it can be due to seasonal allergies (allergic rhinitis or hay fever). Allergies, asthma, and eczema often occur together. They are called the atopic triad.¹

It is also possible to have areas of gray or purple-colored darkening around the eyes. These are called allergic shiners.^1,2

Some people with eczema also have extra folds of skin under the lower eyelid. These lines may be a sign of swelling or inflammation. They are called Dennie-Morgan lines.^1,2

Potential eye issues with eczema

There are also other eye issues that can occur with eczema. Examples of these include:^1-6

• Atopic keratoconjunctivitis (ACKC) or vernal keratoconjunctivitis (VKC): These are chronic allergic diseases of the eyes. People with AKC or VKC have eye tearing, itching, and burning. They also have mucus discharge from the eyes and an increased risk for eye infections. Vision loss can occur as well. These conditions need to be assessed by an eye specialist (ophthalmologist).
• Conjunctivitis: Conjunctivitis is inflammation of the conjunctiva that can be due to an infection or allergies. The conjunctiva is the film that lines the eyeball and eyelid. Conjunctivitis is also known as pink eye. It can lead to light sensitivity, itchiness, pink or red eyes, and sticky or crusty eyes.
• Keratitis: Keratitis is inflammation or infection of the cornea. The cornea is a clear layer of tissue that protects the front of the eye. It also helps with vision and filtering out light. A person with keratitis might have pain in their eyes and be sensitive to light. Their eyes may also feel gritty or like they have something stuck in them.
• Keratoconus: Rubbing or itching of the eyes over time may change the shape of the cornea. This can affect vision. People with keratoconus may start having blurry vision or an eyeglass prescription that changes.
• Blepharitis: This condition is inflammation of the eyelid skin usually by bacteria. It often comes alongside a type of skin inflammation called seborrheic dermatitis.
• Cataracts: A cataract is an area of clouding in the lens of the eye. Cataracts can lead to vision loss over time. Cataracts tend to develop in both eyes as people with or without eczema age. These are thought to be related to long-term scratching or rubbing of the eyes.

This is not a full list of all potential eye-related issues for people with eczema. If you notice any new or worsening eye symptoms or changes in vision, contact your doctor as soon as possible.

Treating eczema of the eyes and other eye-related issues

Watching for eye symptoms and treating them quickly is key in eczema. Many of these issues can cause serious problems over time if not addressed. Some may even cause vision loss if not treated.³

Treatment options vary based on the issue. Infections of the eyes may need to be treated with antibiotic drugs or eye drops. If eye irritation stems from allergies, avoiding triggers, taking antihistamine drugs, or using eye drops may be helpful. Severe cataracts that affect vision may need to be removed with surgery.^4,5

Dry skin, inflammation, and itching of the eyelids can be managed with regular moisturizing. In some cases, topical creams that contain steroids or calcineurin inhibitors can be helpful. But the eyelid skin is much thinner than other areas of the body. Some creams can cause damage to eyelid skin. Talk to your doctor before trying any new lotion or emollient on your eyes.^4,7

If you have more severe eye issues or chronic symptoms, your doctor may need to refer you to an ophthalmologist. These doctors specialize in treating eye conditions.³