Eczema Eye Complications: How to Protect Your Vision

People with eczema are accustomed to the dry, itchy skin and red rashes that go along with a flare-up. These episodes show up mostly on the face, inside the elbows, behind the knees, and on the hands and feet — though they can happen anywhere, including the eyelids, eyebrows, and even eyelashes, according to the Cleveland Clinic.

Atopic dermatitis, the most common type of eczema, 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 (AAD).

Indeed, according to DermNet NZ, 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.

Eczema, Your Eyes, and the COVID-19 Pandemic

During the COVID-19 pandemic, some doctors are noticing an increase in eczema around the face and eyes in their patients.

“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, who has observed this trend during the pandemic.

Symptoms of Eczema 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 red and scaly,” Seitzman says. “Often the skin itches a lot and can also become red and sometimes swollen.”

According to Evan Rieder, MD, a dermatologist at NYU Langone Health in New York City, other signs of eye complications due to eczema include:

  • Issues with vision
  • Irritation or pain of the eyeball
  • Pink or redness in the eye
  • Eyelid swelling
  • Drainage from the eye

Eye Complications Due to Eczema

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 in the 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 eyelids and itchy eyes, he notes.
  • Greater risk of cataracts Having atopic dermatitis can also increase your risk for 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 (AAO).
  • Spontaneous retinal detachment Research suggests this condition, when 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.

Treatment for Eye Complications Linked to Eczema

There are many creams and ointments for the treatment of atopic dermatitis, ranging from over-the-counter preparations to prescription corticosteroid creams, Seitzman says.

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