Study Links Atopic Disease to Increased Risk of Astigmatism in Adolescents

Itchy eyes, blurry vision? Atopic disease may be warping more than sinuses—it could reshape the eye.

A new population-based study has identified a significant association between atopic disease, particularly ocular atopic disease (OAD), and astigmatism in adolescents and young adults.

The research, published in Eye, analyzed nearly 900,000 medical records and found that individuals with OAD had notably higher odds of developing astigmatism compared to those without atopic conditions.¹

Study author Dr. Itay Nitzan shares key findings on his LinkedIn page.

Key findings

The study reviewed 897,811 medical records of Israeli adolescents and young adults (mean age 17.2 years) who did not have keratoconus. Researchers assessed the prevalence of low-to-moderate (0.75 D to <3.00 D) and high (≥3.00 D) astigmatism in individuals with and without atopic diseases, including asthma, allergic rhinitis, atopic dermatitis, angioedema/urticaria and anaphylaxis.

Among the cohort, 4,702 individuals (0.5%) had OAD. This group exhibited increased odds of both low-to-moderate astigmatism and high astigmatism. Additionally, those with OAD showed a greater likelihood of developing with-the-rule (WTR) astigmatism. Other atopic diseases were associated with smaller increased risk for both low-to-moderate astigmatism and high astigmatism, with no preference for axis orientation.

Potential mechanisms and implications

While the study did not establish a causal relationship, researchers suggest that pressure on the cornea from factors such as chronic eye rubbing or inflammation may contribute to the increased prevalence of astigmatism in patients with OAD. The sensitivity analysis further indicated a dose-response relationship, with greater OAD severity linked to higher odds of astigmatism.

Dr. Sermed Mezher discusses a case where a patient rubbed his eye blind.

The findings highlight the need for effective management of OAD, as uncorrected astigmatism can impact visual function, quality of life and economic burden. The authors emphasize the importance of early detection and intervention in patients with atopic disease to mitigate potential ocular complications.

Study limitations and future research

As a retrospective study, the analysis was limited by the use of medical coding data, which may not fully capture disease severity or progression. Additionally, the study could not distinguish between different forms of ocular atopy, such as atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC).

Future prospective research incorporating corneal tomography and inflammatory biomarker assessments may help clarify the underlying mechanisms of the observed association.

This study adds to the growing body of evidence linking atopic disease to ocular changes and underscores the importance of comprehensive eye care in this population.