Abstract

OCULAR MANIFESTATIONS OF ATOPIC DERMATITIS- AN OBSERVATIONAL STUDY IN A TERTIARY CARE CENTRE IN WESTERN ODISHA

Author(s): Swati Samikshya1, Jagadish Prasad Rout2, Sahoo Soni3, Jayashree Dora4, Kanhel Charan Tudu5

BACKGROUND
Atopic dermatitis (AD) also known as atopic eczema, is an allergic condition with hereditary predisposition. It mostly presents with intensely itchy skin, raised, splotchy lesions anywhere throughout the body. AD is most commonly seen in younger age group, the severity increases with increasing age. It is a chronic allergic condition, having both dermatologic as well as ocular manifestations. Ocular manifestations and its complications of AD are proven to be potentially morbid. The aim of this study was to evaluate the frequencies, prevalence and pattern of ocular manifestations in patients with Atopic Dermatitis in our Tertiary eye care center in Western Odisha, so that early diagnosis and treatment of symptoms can be effectively done to prevent complications.
MATERIALS AND METHODS
A Hospital based observational study of Ocular manifestations in 80 cases of Atopic Dermatitis was done over 12 months. To study the frequency of ocular symptoms and its complications, a study group comprising of 49 males and 31 females were examined thoroughly. Associated ocular signs, anterior segment of eye and fundus were examined.
RESULTS
Atopic keratoconjunctivitis (AKC) having the maximum contribution (38.8%) followed by severe blepharoconjunctivitis (20.3%) was found in our study. Lid involvement appeared as thickening, scaling and Dennie Morgan folds, while conjunctival changes were seen in form of severe follicular and moderate to severe papillary reactions with limbal thickening. Cobblestone appearance of papillae were typically found along with papillary hypertrophy. The ocular abnormalities were mostly found in the age group of 0-10 years with an average duration of suffering from AD of >1 year. The ocular manifestations in our case group were not significantly associated with visual impairment or any serious morbidity.
CONCLUSION
Atopic dermatitis is a chronic allergic condition which when presents as ocular manifestations presents mostly with rubbing of eyes which eventually presents as lid thickening and scaling along with red itchy raised lesions like any other part of the body involved due to AD. The inflammatory reactions due to hypersensitivity, raised immunoglobulins like IgE and interleukins and other inflammatory mediators leads to conjunctivitis which eventually involves cornea leading to keratitis also. Complications like keratoconus, uveitis, anterior and posterior sub capsular cataract etc. were not found in our study which can be found with following up the patients for quite a longer time. The severity of the ocular manifestation can be perpetually correlated with the duration of the disease suffered by the patient. This is a condition which is mostly found in younger age group, and our study also could correlate with previous results.