Atopic dermatitis is the most common type of eczema and it can develop around the sensitive eye area and lead to a number of eye problems for anyone living with the condition, says the American Academy of Dermatology. Indeed, the eyelids are particularly sensitive to irritants. If you expose your eyelids to an irritant, they are more likely to flare up than other parts of your skin. “One possible reason could be that with increased contact of numerous types of fabric to the skin, this population with increased incidence of contact dermatitis could be reacting to the mask materials,” says Gerami Seitzman, MD, an ophthalmologist and the medical director of the Francis I. Proctor Foundation for Research in Ophthalmology at UCSF Health in California. Increased use of hand sanitizers and soaps can also worsen skin irritation, Dr. Seitzman adds. “Lastly, in colder climates, parts of the skin being exposed to cold, dry outdoor air can dry the skin of its natural moisture, so it is possible with the face covered, more of the inclement conditions affect the skin around the eyes,” she says. To prevent vision trouble, see your doctor as soon as you notice any eczema-related eye complications.
What Causes Eye Complications Tied to Atopic Dermatitis?
Compared with the general population, people with atopic dermatitis have an increased risk of developing eye diseases, according to a study published in 2017 in the Journal of the American Academy of Dermatology. Additionally, individuals with severe eczema were more likely to have eye complications than those with mild cases. The reason for this lies in the very nature of this skin condition. “People with eczema often are atopic, meaning they have a tendency to be allergic to many substances,” explains Seitzman. “When the delicate lining on the surface of the eye responds to numerous allergens, the eye itself can become red and inflamed.” What’s more, patients with eczema are more prone to infections in and around the eyes, Seitzman says. “When eyes itch severely, some people rub their eyes repeatedly and aggressively,” she says. “This constant eye rubbing can also cause eye damage.”
Symptoms of Atopic Dermatitis Eye Complications
Experts say there are a number of signs people with atopic dermatitis around their eyes should look out for that may signal something is wrong. “When eczema affects the skin around the eyes, that skin can become irritated and scaly,” Seitzman says. “Often the skin itches a lot and can also become irritated and sometimes swollen.” According to Evan Rieder, MD, a dermatologist and assistant professor of dermatology at NYU Langone Health in New York City, other signs of eye complications due to eczema include:
Issues with visionIrritation or pain of the eyeballPink or redness in the eyeEyelid swellingDrainage from the eye
What Eye Complications May Be Due to Atopic Dermatitis?
Atopic dermatitis can cause a variety of eye problems including:
Keratitis, or Inflammation of the Cornea Atopic dermatitis can lead to irritation and inflammation of the cornea, the clear, dome-shaped tissue on the front of the eye, says Dr. Shahzad Mian, an ophthalmologist and professor of ophthalmology and visual sciences at University of Michigan Medical School. This can lead to “pain, light sensitivity, and loss of vision,” he says. “In severe cases, vision loss can be permanent.”Keratoconus Eczema around the eyes can sometimes lead to a condition in which the cornea bulges outward. “Since itchy eyes and discomfort can lead to rubbing of eyes, there is also an association with keratoconus, with irregularities in the shape of the cornea and progressive vision loss,” Dr. Mian says.Conjunctivitis People with atopic dermatitis around the eyes are more prone to eye infections, including pink eye, or conjunctivitis, Mian says. This can be associated with redness, tearing, crusting of the eyelids, and itchy eyes, he notes.Greater Risk of Cataracts Atopic dermatitis can also increase your risk of developing cataracts, or cloudiness that forms in the normally clear lens of the eye, later on. “Atopic cataracts develop in patients with long-standing atopic disease of 10 or more years,” says Tanya Kormeili, MD, a clinical professor in the department of dermatology at the UCLA David Geffen School of Medicine and a dermatologist in private practice in Santa Monica, California. Cataracts can lead to vision problems and can be removed only with surgery, according to the American Academy of Ophthalmology.Spontaneous Retinal Detachment Research suggests that this condition, in which the retina becomes separated from its supporting tissue, is more common in patients with atopic dermatitis than in the general population.Scarring Finally, in very rare cases, scarring can occur in various parts of the eye, Mian says.
Keeping Your Eyes Safe From Eczema
“Notify your doctor as soon as symptoms begin,” says Dr. Kormeili. Be prepared for the doctor to examine your eyes and ask when the symptoms began and if anything in particular may have caused the flare-up. “Often, but not always, people with eczema have known triggers to their flares,” Seitzman says. “Sometimes the trigger can be certain seasons or sometimes certain chemicals or other irritants. It is good to avoid contact with known triggering agents. Sometimes specialized patch testing can help reveal which triggers to avoid.” Dr. Rieder also advises keeping your skin clean and moisturized. “Cleanse with hydrating cleansers, and moisturize with hypoallergenic ointments or creams around the eyes regularly,” he says. To reduce the chance of skin infections and eye problems, it is important to avoid rubbing and scratching the area, Seitzman says. Keep your fingernails short to prevent extra damage if scratching does occur. “Cool compresses are good tools to minimize the itching sensation,” Seitzman adds. “Antihistamine drops are good to minimize ocular itching.”
Treatment for Eye Complications Linked to Atopic Dermatitis
There are many creams and ointments for the treatment of atopic dermatitis, ranging from over-the-counter preparations to prescription corticosteroid creams, Seitzman says. Never use any of these on the eye area without consulting a doctor, because, as research published in 2017 in the Journal of Current Glaucoma Practice suggests, the use of topical steroids may be associated with glaucoma, probably from the cream seeping into the eyes. In some cases, your doctor or dermatologist may recommend treatment by an ophthalmologist. “Any time inflamed eyes and eyelids are associated with decreased vision, an ophthalmologist should be brought in as part of the evaluation team,” Seitzman says. “When steroids are used around and in the eyes, it is very important for an ophthalmologist to follow along so that eye pressure can be monitored. Steroids can affect the eyes in several ways, and monitoring for these side effects requires specialized tools to measure and visualize eye health.” Ultimately, while atopic dermatitis of the skin around the eyes can be challenging to control, with proper treatment it can be managed — and you can protect your vision.
