Ocular Rosacea

General Information

It is reported that about half of all Rosacea sufferers also have some sort of symptoms with their eyes which is known as Ocular Rosacea. One study (Starr, McDonald 1969) found ocular rosacea symptoms in 58% of patients.

Sometimes (perhaps 20% of the time) eye problems precede the typical skin related rosacea symptoms though it more usual (about 53% of the time) for the skin symptoms to appear first.  (Borrie, 1953).

Symptoms & Medical Conditions

Symptoms of ocular rosacea include dry eyes or tearing, redness, burning, pain or a feeling that something is in the eye - perhaps a gritty feeling. (Jenkins 1979). Also, scales and crusts on the eyelids, sensitivity to light and blurry vision

Specific conditions include:

Inflammation of eyelashes or lid margins, the generic term for which  is blepharitis.  Blepharitis often results in red, itchy, burning eyes and lashes as well as scales and crusts on the eyelids. Included in this group of conditions are sties which are infections of eyelash follicles.  Other conditions include an enlarged / inflamed or plugged meibomian gland (the gland which lubricates the eyelids) which is called chalazia or meibomitis. Problems with the meibomian gland may result in dry eyes 

Red, painful eyes may be the result of conditions known as episcleritis and scleritis. Both conditions involve inflamed blood vessels in the eye.

Keratitis is one of the more serious conditions which may occur in relation to ocular rosacea.  Keratitis is a term which is used to a range of conditions where there is infection or inflammation of the cornea. This condition may result in severe eye pain, blurry vision and sensitivity to light.  Medical evaluation and treatment of keratits is absolutely essential.

iritis - Inflammation of the iris, a part of the eye. Symptoms include eye pain, sensitivity to light, and/or blurry vision. The symptoms of this may resemble conjunctivitis.

Treatment

Blepharitis - The most important part of treatment of many forms of eyelid inflammation and infection is lash hygiene. Clean eyelashes carefully every morning with a warm, moist wash-cloth. Soak the lashes with this cloth, and then scrub the lid margin to remove the scales and crusts that have accumulated overnight. Some physicians recommend scrubbing the lashes with baby shampoo as well.  Remember to remove all mascara before going to bed

In addition the following advice may also apply

sties: The best thing for a stye is a hot compress. Apply a warm, moist washcloth to your lids for 5 minutes, four times a day. Within a few days the infection will either die down or come to a head and drain.

chalazian (bumps on eyelids) : Hot packs are the best treatment for these infections, also. However, if the bump fails to go away in a month it may be necessary to drain it. This is done in your Ophthalmologist's office.

To prevent infections from recurring,  it is important to keep your lids and lashes clean by following the eye care routine described above.

Keratitis : Minor corneal infections are commonly treated with anti-bacterial or anti-fungal eye drops. If the problem is more severe, a person may receive more intensive antibiotic treatment to eliminate the infection and may need to take steroid eye drops to reduce inflammation.  

Blephamide is one specific type of steroid eye drop which some sufferers have had some success with. Use of these types of drops require careful monitoring by a physician. It is usually suggested that this product be used daily for between 3 days & 1 week followed by a break (or tapered use) for the next 3 - 4 weeks. (Blephamide is also available as an ointment.)

Antibiotics from the tetracycline family such as doxycycline and minocycline are often prescribed to bring symptoms of ocular rosacea under control.  Studies of the use of doxycycline by patients with ocular rosacea showed significant improvement with a variety of signs/symptoms including dryness, itching, blurred vision and photosensitivity, scales, erythema and telangiectasia (Quarterman 1997)

For dry eyes, some rosacea sufferers use Celluvisc Eye drops  found at drug stores or grocery stores. They are much thicker than the usual eye drops and can be used without taking out contact lenses. Because of the thickness of the eye drops, they may temporarily impair vision.

Further Reading

References

  • Starr PAH, McDonald A. Oculocutaneous aspects of rosacea. Proc R Soc Med. 1969;62:9.
     

  • Borrie P. Rosacea with special reference to its ocular manifestations. Br J Ophthalmol. 1953;65:458.
     

  • Browning DJ, Proia AD. Ocular Rosacea. Surv Ophthalmol. 1986;31:145-158.
     

  • Jenkins MA, Brown SI, Lempert SL, al. e. Ocular rosacea. Am J Ophthalmol. 1979;88:618-622.
     

  • Quarterman MJ, et al. Ocular rosacea. Signs, symptoms and tear studies before and after treatment with doxycycline. Arch Dermatol 1997;133:49-54.

 

 

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