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Atopic Dermatitis Leading to Blindness: A Frequently Forgotten Sequelae.

Mohd Khairrudin M Mohd Sobri1, Mae-Lynn Catherine Bastion2,3, Chenshen Lam3

  • 1Opthalmology, Hospital Universiti Kebangsaan Malaysia, Kuala Lumpur, MYS.

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Summary

A child with severe atopic dermatitis experienced vision loss due to retinal dialysis. Prompt diagnosis and management of atopic dermatitis are crucial for preventing serious eye complications in children.

Keywords:
atopic dermatitiseczemapars plana vitrectomyretinal detachmentretinal dialysis

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Area of Science:

  • Ophthalmology
  • Dermatology
  • Pediatrics

Background:

  • Atopic dermatitis (AD) is a chronic inflammatory skin condition often associated with ocular comorbidities.
  • Children with poorly controlled AD may present with various eye issues, necessitating thorough ophthalmic evaluation.

Observation:

  • A 12-year-old boy with severe, poorly controlled atopic dermatitis, atopic conjunctivitis, and rhinitis presented with two weeks of painless blurred vision in his right eye.
  • Ophthalmic examination revealed decreased visual acuity (1/60), a relative afferent pupillary defect (RAPD), anterior uveitis, posterior subcapsular cataract, and a hazy fundus view.

Findings:

  • B-scan ultrasound suggested a shallow total retinal detachment.
  • Intraoperative findings confirmed a large retinal dialysis in the affected eye.

Implications:

  • This case underscores the importance of suspecting retinal dialysis in pediatric patients with atopic dermatitis presenting with vision changes.
  • Effective management of systemic atopic dermatitis is critical for preventing severe ocular morbidity, including retinal detachment, in children.