Can A Dermatologist Treat Ocular Rosacea & Can You Wear Eye Makeup When You Have It?

The ocular form of rosacea affects the eye making it watery with a feeling of tingling. The eye also becomes photosensitive with enlarged eyelids and conjunctiva. Often overlooked, it could affect up to 9% of the population, 5% being diagnosed by a dermatologist.

People with rosacea of the eye are often under the care of a dermatologist and are referred for treatment when the patient develops an associated eye disease. However, an ophthalmologist can also make a preliminary diagnosis through routine eye examinations and skin assessments.⁽¹⁾

Controlling skin inflammation can significantly relieve eye conditions. Therefore, ophthalmologists and dermatologists usually prescribe together to treat the problem. Eye-related symptoms can usually be relieved by applying warm (not hot) pressure to the eyelids, eyelid scrubs, and artificial tears. Topical and oral antibiotics can also be prescribed to reduce symptoms.

About half of rosacea patients have rosacea in the eyes. The degree to which the eyes are affected does not seem to be related to the severity of facial inflammation. For example, you may have severe rosacea on your face and little or no problems with your eyes. Similarly, mild rosacea may be accompanied by severe eye rosacea.

The common complaint is dry eyes and irritation. These symptoms can be relieved by over-the-counter eye drops but if this does not solve the situation then you must see a doctor.⁽²⁾⁽³⁾

Use highly gentle eye makeup when you have ocular rosacea. Sensitive eye products can help you in this situation. fragrance-free and allergy-tested eye products.

The consequences of chronic meibomitis are not limited to the dry eyes alone. There are more or less severe palpebral, corneal and conjunctival complications, some of which can irreversibly affect the visual functional prognosis.

The most serious and very often overlooked conjunctival complication is fibrosis, which initially takes on the appearance of whitish streaks, readily tree-like or coarsely starred. The evolution is sometimes done towards a progressive filling of the conjunctival pouches and the constitution of symblepharon. These complications are constantly accompanied by changes in the architecture of the eyelid edges which are thickened, irregular and the site of significant vascularization. There is often a secondary ciliary malposition that maintains conjunctival inflammation and may be responsible for keratitis.

The corneal complications of ocular rosacea are represented by keratitis which can take on a wide variety of clinical aspects. Most often it is punctate superficial keratitis classically predominant in the lower part of the cornea. A more specific form of corneal involvement is interstitial keratitis made up of often multiple peripheral opacities and vascularized by a brush of superficial new vessels coming radially from the limbus.

In children and sometimes in adults, this type of corneal injury occurs in the context of phlyctenular keratoconjunctivitis. Inflammatory recurrences are painful and can even lead to corneal perforation. The other corneal complications of rosacea are catarrhal infiltrates, often ulcerated, peripheral neovascularizations of any form, and peripheral inflammatory thinning.⁽⁴⁾⁽⁵⁾

It is important to see a doctor if you develop symptoms of ocular rosacea. The rosacea is not curable, but there are treatments to help control the symptoms of rosacea. The earlier the medical intervention, the better, as it is often easier to control the symptoms.

While the symptoms of rosacea are usually treated with a topical antibiotic applied directly to the problem areas, ocular rosacea is more often treated with an oral antibiotic.

The tetracycline and doxycycline are commonly prescribed for this condition. Antibiotic courses can be effective in six weeks, but low-dose versions are sometimes prescribed for long periods.

Although oral antibiotics are the most common treatment for ocular rosacea, topical cyclosporine has been reported to improve rosacea symptoms better than doxycycline.
Your doctor may also prescribe prescription eye drops containing steroids. These decrease the inflammation and tend to relieve the problem within a few days. Steroid eye drops are not intended for long-term use.

• Over-The-Counter Solutions
• For dry eyes, over the counter saline solutions (eye drops) are useful. These can lubricate the eye and help prevent damage to the cornea.

However, eye drops intended to lighten red eyes should be avoided. These can worsen your symptoms in the long run.⁽³⁾

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