Neurodermatitis: Risky conjunctivitis caused by pollen

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The pollen season is in full swing. For many, the flying plant dust is now causing red and itchy eyes. Neurodermatitis sufferers then have to be particularly careful: "They are particularly prone to non-infectious conjunctivitis," explains Prof. Philip Maier from the Ophthalmology Clinic at the Freiburg University Medical Center.

This could be triggered or intensified by pollen and then be particularly difficult. Doctors refer to it as atopic keratoconjunctivitis (AKK). "If left untreated, it can cause corneal complications and thus threaten eyesight," emphasizes the ophthalmologist.

Cracks in the skin and scales are alarm signals

AKK initially manifests itself like a "normal" conjunctivitis: the eyes water, are reddened and itchy, and the patient often feels a foreign body sensation in the eye. However, the symptoms are often more severe than those of purely allergic conjunctivitis.

And there are important differences: the edge of the eyelid thickens, skin changes such as flaking, wrinkles and small cracks appear on the lower eyelid. The complaints did not often improve over a long period of time despite taking care measures, explains Maier.

In extreme cases, there is a risk of blindness

In severe cases, superficial defects up to ulcers can develop on the cornea, or blood vessels grow in, which in extreme cases can lead to blindness due to complete opacity of the cornea. Heavy eye rubbing can further promote corneal complications, according to a new study. Children especially find it difficult to cope with the itching.

The cause of the complication could be filaggrin, a structural protein that can be found in the skin as well as the cornea of ​​the eye. In patients with neurodermatitis, the filaggrin production is defective, according to the researcher.

Atopic dermatitis sufferers should see a doctor quickly if they have symptoms

"Anyone who suffers from neurodermatitis and notices signs of conjunctivitis should consult an ophthalmologist quickly," advises Maier. This also applies to people who only have neurodermatitis in their families. A hidden atopic predisposition is also possible with them.

"The wearing of contact lenses should be avoided during conjunctivitis," adds the DOG expert.

Regular ophthalmological checks

Daily eyelid care is necessary to get an AKK under control. This includes carefully cleaning the eyelid rims with damp cotton pads or cotton swabs. It also helps to put on a heat mask that is heated in the microwave or oven.

Gels or tear substitutes without preservatives, which also wash out pollen, help against dryness and itching. If the itching is severe, antiallergic eye drops can be dripped in several times a day (e.g. antihistamines or mast cell stabilizers). You can prevent the release of histamine - or at least suppress its effect and thus alleviate the allergy symptoms.

"In stubborn AKK cases, immunomodulatory eye drops such as ciclosporin A are used," explains Maier. If the course is very severe, surgical interventions on the eyelids and the surface of the eye may be necessary.

Regular ophthalmological checks are particularly important in the case of an AKK in order to avoid long-term consequences. "And for the treatment of the underlying disease, neurodermatitis, an allergist or dermatologist must be called in," emphasizes Maier.

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