Deutsche Ophthalmologische Gesellschaft (DOG), the scientific association of ophthalmology in Germany, has summarised the latest findings on atopic dermatitis and the eyes (DOG May 2020) (in German).
Prevalence: Around 25 to 40 per cent of people with atopic dermatitis also have severe conjunctivitis. When the eyes are affected, it is referred to as atopic keratoconjunctivitis (AKC).
Symptoms: AKC is similar to ‘normal’ conjunctivitis. The eyes become itchy and red. Swollen eyelids and a foreign body sensation in the eyes also occur. In people with only allergic conjunctivitis (without atopic dermatitis), the symptoms are usually milder.
Possible complications: AKC can lead to changes in the cornea and cause impaired vision. Researchers in Israel have discovered that vigorous rubbing of the eyes when they itch can damage the cornea, especially in children (Ben-Eli 2019).
Treatments: An important part of therapy is to perform daily eyelid margin care by carefully cleaning the eyelid margins with moist cotton pads or buds and applying a heated eye mask warmed in a microwave or oven.
Gels or artificial tears without preservatives, which also wash out pollen, can help against dryness and itching. For severe itching, allergy eye drops can be used several times a day.
Sources
Ben-Eli H et al. Pathogenesis and Complications of Chronic Eye Rubbing in Ocular Allergy. Cur Opin Allergy Clin Immunol. 2019;19(5):526-34.