Ocular Comorbidities of Atopic Conjunctivitis and Management of Conjunctivitis on Dupilumab Treatment

Atopic conjunctivitis is characterized by eye redness, itching, and eye rubbing. Uncontrolled atopic ocular disease can lead to keratoconjunctivitis, which may result in corneal scarring. Vigorous eye rubbing alone contributes to serious ocular complications such as retinal detachment, keratoconus, and cataract. Treatment of atopic eye disease is based upon the severity of presentation and should aim to decrease recurrent flares of ocular inflammation. Co-management with ophthalmology is the key if there are vision changes or when patients do not respond to over-the-counter therapy. Topical corticosteroids may be necessary to control atopic eye disease, but recurring ophthalmic evaluations are critical to screen for secondary effects such as glaucoma and cataract. Dupilumab, an effective medication for atopic dermatitis, can induce or exacerbate conjunctivitis. New ocular symptoms after dupilumab initiation warrant ophthalmology referral.