Atopic Dermatitis Associated With Increased Cataract Risk in Pediatric Patients

Eczema around the eye. Close-up of the eye of a 51-year-old female patient with eczema (red) affecting the lower eyelid. Eczema is a common skin condition that causes inflammation of the epidermis (dermatitis), flaking of the skin and small blisters.
Lens densitometry values significantly higher in children with atopic dermatitis.

Pediatric patients with atopic dermatitis (AD) may be at increased risk of developing cataracts, according to researchers. A study published in Dermatologic Therapy now demonstrates that lens densitometry changes in pediatric patients with AD independent of treatment. 

The prospective, comparative study examined 31 pediatric patients who presented with AD (13 males), as well as 20 age-matched healthy children, (9 males). Patients were all seen by the same ophthalmologist and dermatologist between December 2018 and May 2019. 

Study participants underwent a full ophthalmic examination including best-corrected visual acuity, intraocular pressure measurement, slit-lamp biomicroscopy, fundus examination, axial length measurements, and Scheimpflug imaging, and corneal and lens densitometry. Average lens densitometry measurements were taken as well as measurements from zones 1, zone 2, and zone 3. Additionally, researchers performed refractions using an automatic refractive keratometer for all participants and were recorded in spherical equivalent.

An analysis shows that both the average lens densitometry values, as well as values for all 3 zones, were significantly higher in participants with AD compared with controls (P <.05). No statistically significant differences between the control group and the AD group were found in best-corrected visual acuity, axial length, or refractive error measurements (P >.05).

Between 5% and 38% of adolescent and adult patients with AD develop cataracts, making it the most common skin disease associated with cataracts in either group. Although researchers say the pathophysiology between the conditions is not yet clearly understood, this report speculates that frequent, blunt eye scratching could break down the blood-aqueous barrier and result in the release of proteinaceous particles into the anterior chamber, which sets the development of cataracts into motion. 

AD has been implicated in several ocular conditions including blepharitis, keratoconjunctivitis, dry eye, keratoconus, uveitis, and cataracts in pediatric and adult patients alike. While there is speculation that steroids, a treatment used for AD, can cause changes within the lens, the literature shows little prior research that examines the effects of the condition itself on the lens within the pediatric population.

“Routine ophthalmologic examinations are not performed in patients with AD since only a limited number of dermatologists are aware of the risk of developing cataracts independent of treatment in patients with this condition,” the researchers report. They advocate for early ophthalmologic examinations in all pediatric patients diagnosed with AD with a particular emphasis on lens densitometry values.


Mavise Y, Sevil K. Evaluation of lens clarity in children with atopic dermatitis: A densitometric analysis with Pentacam. Dermatol Ther. Published online December 5, 2020. doi:10.1111/dth.14634