People with atopic eczema have an increased risk of developing serious eye disease, including keratoconus (KC), according to a large population-based analysis of UK health records.

Researchers at the London School of Hygiene & Tropical Medicine analysed primary care and hospital data for around three million people with atopic eczema and 14 million matched healthy individuals, tracking hospital-recorded diagnoses over up to 25 years. Writing in Nature Communications, the team said it found people with eczema were around twice as likely to later receive a hospital diagnosis of KC compared with those without eczema. Cataract risk was also elevated, with records showing diagnosis around 1.6 times more likely in the eczema group.

Researchers suggested several possible mechanisms, including chronic eye rubbing, shared inflammatory pathways and barrier dysfunction, which may predispose some patients to corneal disease. Greater awareness of KC and other eye complications in people with moderate to severe eczema could support earlier detection and referral, particularly in younger patients, they concluded.