Typically, we associate deteriorating eyesight with aging. But for people living with eczema, a serious eye problem can show up during the teenage years. Whether you or your child has eczema, here’s what you need to know about a condition called keratoconus, including the warning signs that indicate your potential risk and how to treat the condition once you’ve been diagnosed.
While the causes of keratoconus are not fully understood, it is a known complication of eczema (as well as other conditions) related, in part, to vigorous and long term itching or rubbing of the eyes. With keratoconus, the clear, protective outer layer at the front of the eye (called the cornea) becomes thinner and changes shape over time.
Rather than being round or dome-like, corneas affected by keratoconus become progressively more cone-like and may even bulge from their natural position in the eye. Because the cornea plays a key role in focusing light entering the eye, changes in the shape of this structure can have serious consequences for eyesight and, without treatment, can lead to permanent vision loss. Fortunately, there are treatments that, when started early, can help people with keratoconus to maintain their vision and normal lives.
“It’s important to catch this problem early,” says Dr. Jason Dimmig, an ophthalmologist in Bend, OR, and former president of the Oregon Academy of Ophthalmology. “We don’t fully understand keratoconus yet, or why it necessarily happens, but we know that it can progress pretty quickly and we want to catch it and manage it early.”
There is not yet widespread data on exactly how many people have keratoconus. Numbers from the National Keratoconus Association vary from 1 in every 375 people to 1 in every 2,000 people. “It’s not that uncommon,” says Dimmig, “but it’s not that common, either. The biggest risk factor is rubbing your eyes a lot when you’re young.”
Indeed, Johns Hopkins Medicine notes that things that increase a person’s chances of developing keratoconus include: chronic eye rubbing, lasting eye inflammation due to allergies or irritants and family history of the condition.
Important warning signs to watch for, according to the National Keratoconus Association and Mayo Clinic, are:
- Blurred vision (perhaps mild)
- Difficulty seeing at night
- Sensitivity to bright light or glare
- Frequent changes in glasses prescription
- Vision that cannot be corrected with glasses
- Noticeable eye rubbing
Whether a person’s eyes are itchy due to eczema around the eyes or on the eyelids, or if the eyes themselves feel itchy, it’s important to get treatment from your medical team, including a dermatologist and an eye doctor (ophthalmologist) to control the itch and prevent excessive eye rubbing. When diagnosed early, keratoconus can be better managed so vision can be best protected. “There are lots of things we can do,” says Dimmig.
Treatments include medications to easy itch and limit rubbing; specialized contact lenses to help reshape the cornea for improved vision and to help prevent eye changes from getting worse; a newer procedure called corneal collagen cross-linking that uses uaviolet light and a vitamin B solution to help strengthen the cornea; corneal implants; or, for severe vision loss, corneal transplants.
Because keratoconus is often first diagnosed in the teen years, by the time a person reaches their twenties the condition can become quite serious: it’s important for the parents and caregivers of young people living with eczema to be aware of the risks, warning signs, and role of early detection and management. Awareness, education and diagnostics can help to keep eczema eyes healthier.
Talk to your doctor about how often you or your child should be having eye exams and be sure to tell him or her about itchy eyes, vision changes or sensitivities, and any family history of eye problems. If you or a loved one is diagnosed with keratoconus, visit an eye doctor regularly for monitoring and treatment to help keep eyesight the best it can be.
Learn more about keratoconus at NKCF.org.
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