Ophthalmologic Manifestations of Atopic Dermatitis Treatment & Management

Updated: Mar 14, 2019
  • Author: R Scott Lowery, MD; Chief Editor: Hampton Roy, Sr, MD  more...
  • Print
Treatment

Medical Care

No cure exists, and treatment is aimed at the multifactorial nature of the disease. [8]

The most commonly used treatments include stress control, avoidance of allergens (most commonly dust mites, peanuts, egg, milk, fish, rice, soy, and wheat), and irritants (particularly chemicals, soaps, heat, humidity, wool, and acrylic).

Atopic dermatitis frequently can be controlled with topical steroids. While topical steroids are known to be related to development of cataracts and increased intraocular pressure, a recent study that evaluated glaucoma risk found only a modest rise in intraocular pressure. However, that rise was statistically significant, and intraocular pressures should be monitored closely in patients on topical steroids, particularly when their intraocular pressure is higher at baseline. [9]

Management of atopic dermatitis and AKC is similar to management of vernal keratoconjunctivitis (VKC), but the chronic nature of AKC requires more prolonged treatment.

The treatment regimen for AKC typically consists of topical steroids, mast cell stabilizers, systemic antihistamines, and systemic and topical antibiotics. [10]

Recent studies have shown that patients with eye involvement may have an increased likelihood of food sensitivity.

Next:

Consultations

Ophthalmic consultation is recommended if eye involvement is noted. Dermatology consultation may be necessary to confirm a diagnosis of atopic dermatitis. [11]

Previous
Next:

Diet

Patients with known atopic disease may have various food allergies that trigger or exacerbate their disease. Avoidance of these foods is essential.

Previous
Next:

Complications

The use of corticosteroids is fraught with potential ocular and systemic complications. In particular, cataract formation, glaucoma development, and potential corneal thinning must all be considered when deciding to use steroids for this disease. Long-term use should be avoided if at all possible.

Previous
Next:

Prevention

Stress control, avoidance of allergens (most commonly dust mites, peanuts, egg, milk, fish, rice, soy, and wheat), and irritants (particularly chemicals, soaps, heat, humidity, wool, and acrylic) may help control the disease.

Previous
Next:

Long-Term Monitoring

Prophylaxis against scratching should be taken.

Scratching the lesions can worsen them and lead to the lichenification process characteristic of long-standing disease.

Corneal abrasions and further eye irritation also may occur. Antihistamines, mast-cell stabilizers, and corticosteroids will aid in reducing the itching but may require some time to take effect.

Nails should be kept clean and trimmed.

In pediatric patients, mittens may be used at night or even daily, when possible, if itching and scratching are severe.

Previous