Ophthalmologic Comorbidities in Alopecia Areata

Alopecia areata (AA) is a complex disease with a multifactorial etiology, in which autoimmune mechanisms play a central role. Increasing evidence suggests that AA may be a systemic condition, potentially affecting organs beyond the skin due to shared pathogenic pathways. One proposed mechanism is the breakdown of immune privilege, a protective state that limits immune activity in specific tissues, such as the hair follicle and the eye. Although research on the relationship between AA and ophthalmic comorbidities remains limited, several studies have reported recurrent ocular abnormalities, whether subclinical or symptomatic, appearing at younger ages than typically observed in the general population. This review aims to summarize current knowledge on the association between AA and ocular involvement, exploring shared pathogenic mechanisms, clinical eye manifestations, and practical considerations for addressing ocular symptoms in dermatological practice.