Itching in the eye area occurs with conjunctivitis, keratoconjunctivitis, blepharitis, eyelid dermatitis, meibomitis, chalazion, demodicosis, dirofilariasis and other ophthalmic diseases. It is often the result of an allergy. May be a physiological response to various irritants. The cause is determined on the basis of the clinical picture and data from additional studies. Treatment is often topical. Includes antimicrobial therapy, hormones, other drugs. Some patients require surgery.
The short-term appearance of the symptom is due to irritation of the eyelids, conjunctiva and lacrimal glands. The provoking factors are:
Conjunctivitis is a large group of inflammatory diseases of the conjunctiva of various etiologies. Common signs are burning, itching, gritty sensation in the eyes, photophobia, watery eyes, swelling and redness. In clinical practice, bacterial and viral variants of the disease are more common. Fungal and chlamydial lesions are possible. Non-infectious inflammatory processes occur with chemical or mechanical irritation, visual impairment, beriberi, metabolic disorders.
In most cases, both eyes are affected. In the acute form of the disease, the manifestations are pronounced. Pain, cramps, hyperemia of the conjunctiva, swelling of the eyelid area, copious discharge are noted. Possible violations of the general condition. In the chronic form of the disease, discomfort, mild itching, increased fatigue of the visual apparatus prevail.
Angular conjunctivitis debuts with severe itching and burning, to which are subsequently added cramps, as well as pain, aggravated by blinking. The lesion is always bilateral, manifestations increase in the evening. Emitted foamy, then viscous. The deterioration of the general condition is insignificant. Pathology is prone to recurrence.
Keratoconjunctivitis manifests suddenly, in chronic ophthalmic diseases it can develop gradually. Pain, cramps, photophobia and a feeling of a foreign object are combined with a fog before the eyes, a decrease in visual acuity. Adenovirus lesions are characterized by small hemorrhages in the conjunctiva. With bacterial infections, a white-yellow infiltrate forms on the eye.
Itching in the eye area
Typical symptoms of blepharitis are itching, redness and swelling of the eyelids, blurred vision, abnormal discharge, increased sensitivity to wind, bright light and other irritants. Depending on the form of the disease, thickening of the edges of the eyelids, the formation of scales, the formation of ulcers with subsequent scarring of the skin, loss, discoloration or impaired growth of eyelashes is possible.
Eyelid dermatitis is a polyetiological disease. When infected with the herpes simplex virus, blisters form on the skin of the affected area against the background of burning, which become covered with crusts and disappear. There is a high likelihood of recurrence. With seborrheic dermatitis, there is a combination of skin itching, loss of eyelashes and peeling of the skin.
The development of barley begins with itching. Then the affected area quickly becomes painful, swollen, hyperemic. Weakness, general hyperthermia are possible. After 2-3 days, a pustule forms in the center of the infiltrate. After opening the abscess, the symptoms gradually decrease. Meibomitis is characterized by the formation of a purulent focus on the inside of the eyelid. Swelling, redness, severe pain in the affected area, a feeling of a foreign body in the eye are revealed. In the chronic course, the eyelid is thickened, patients are concerned about burning, discomfort.
In people with epicanthus, along with a cosmetic defect, there may be a feeling of "sand", a narrowing of the field of vision, sometimes burning and itching. Chalazion is a rounded dense formation in the thickness of the eyelid. In some patients, it is accompanied by lacrimation, unpleasant sensations when touched. With trichiasis, itching is the result of improper growth of eyelashes. There are lacrimation, pain, photophobia, hyperemia of the conjunctiva.
The symptom is considered one of the main manifestations of demodicosis caused by microscopic mites. The edges of the eyelids are edematous, hyperemic. Eyelashes are surrounded by a "collar". Perhaps a feeling of a foreign object, a feeling of tightening of the skin, loss of eyelashes. Hyperkeratosis develops. Due to severe itching, patients scratch the eye area, the scratches become covered with crusts, become infected. Pathology is often detected in several people in the family.
The cause of dirofilariasis is small roundworms, infection occurs when bitten by mosquitoes. Parasites live in the eyelids or conjunctiva. Initially, patients complain of severe itching, swelling, lacrimation. The formation of a seal is accompanied by reddening of the affected area, blepharospasm, and progressive ptosis. There may be a sensation of movement in the eye or under the eyelid. The movements of the worms are accompanied by severe pain and burning.
Pathology develops with Sjögren's syndrome, endocrine ophthalmopathy, kidney disease. It can be provoked by lagophthalmos, chronic conjunctivitis, other eye diseases, ophthalmic surgical interventions. Significant factors in the development of dry eye syndrome are prolonged work at the computer, incorrect selection or violations of the rules for using contact lenses. Symptoms include cramping, burning, redness, gritty feeling. Intensify in the evening.
Occur due to hypersensitivity to a particular antigen. Bilateral lesion is typical. Symptoms appear in the interval from several minutes to a day or more from the moment of contact with the allergen. There are lacrimation, burning, redness and swelling of the conjunctiva. The itching is so severe that it causes patients to constantly rub the eye area, which leads to an increase in other symptoms. There are the following forms of allergic conjunctivitis:
With simultaneous damage to the conjunctiva and the nasal area, allergic rhinoconjunctivitis occurs. Depending on the nature of the allergen, the pathology can be seasonal or year-round. In the seasonal form, sneezing, lacrimation, copious watery discharge from the nose, itching in the nose and eyes, nasal congestion, and photophobia are observed. The persistent form proceeds smoothly, the symptoms are more permanent. The discharge is mucus, thick, congestion worse at night. Itching in the eye area is not pronounced.
Allergic keratitis is manifested by a corneal syndrome (lacrimation, photophobia, blepharospasm), sensation of a foreign object. Burning, cramps, constant pains that prevent the opening of the eye are revealed. Allergic blepharitis, as a rule, manifests suddenly under the influence of various factors. Patients complain of persistent itching and swelling of the eyelids, cramps, photophobia. The skin around the eyelids darkens. Allergic dermatitis is characterized by redness, rash, severe swelling. In severe cases, Quincke's edema may develop.
Itching in the eye area is observed with Sjögren's disease. It is caused by a decrease in the amount of lacrimal fluid, combined with "sand", "scratching", burning, redness of the eyelids, enlargement of the salivary glands, stomatitis, dry lips and oral cavity. The symptom is also characteristic of cystinosis, in the infantile form it is expressed moderately, in the juvenile and adult forms it is insignificant.
Ophthalmic examination
Diagnostic measures are carried out by an ophthalmologist. If an allergic symptom is suspected, patients are referred to an allergist. During the survey, the specialist finds out when and under what circumstances the symptoms appeared, how the disease developed. In the process of external examination, the doctor assesses the condition of the eyelids, conjunctiva and other structures available for direct examination, determines the presence and nature of the discharge, hyperemia, edema, and other pathological changes.
Special examinations of the eye include visometry, biomicroscopy, fluorescein test. With dirofilariasis, gonioscopy, measurement of intraocular pressure may be required. Demodicosis is confirmed by microscopy. Less commonly, a puncture biopsy of the sebaceous or meibomian glands is performed. If an infectious nature of itching is suspected, a microbiological analysis is performed. In case of allergic diseases, depending on the phase of the process, elimination, exposure or skin-allergic tests are carried out.
The tactics of treatment is determined by the cause of itching in the eye area:
As part of the surgical treatment, the following interventions are performed: