Atopic Dermatitis Leading to Blindness: A Frequently Forgotten Sequelae

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.