Blurred vision
A 32-year-old African American woman presented to her family physician (FP) with an exacerbation of her atopic dermatitis and blurred vision. The FP had been helping to treat her atopic dermatitis for years, but this was the first time the patient had experienced visual blurring. The FP took a closer look at the patient’s eyes and was able to see a change in their anatomy, when looking from the side. The patient admitted to rubbing her eyes frequently.
What’s your diagnosis?
The FP advised the patient that she had keratoconus, a condition in which the cornea bulges out in the middle (like a cone). Keratoconus, which can adversely affect the health of the eye, is one of several eye findings related to atopic dermatitis. Others include recurrent conjunctivitis, cataracts, and periorbital darkening.
The patient in this case was referred to her ophthalmologist for further evaluation and the FP advised her to avoid rubbing her eyes. In some severe cases, keratoconus treatment requires corneal transplantation.
Photos and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Usatine R, Finklea L. Atopic dermatitis. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:584-590.
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