Ocular rosacea is an eye disease that usually affects people with a rosacea skin condition. The disease mainly results in redness, itching and eye irritation. Ocular rosacea is observed in about 20% of patients with skin symptoms. There is no cure for Ocular rosacea, but the management of the symptoms is possible. However, recurrent symptoms are common.(1)
People with rosacea on the eye have the following risks:
- Sensitivity to eyes
- Eye infection
- Vision loss
You can have skin symptoms first or both the eye symptoms first. Women are more prone to develop skin rosacea, but in both men and women, ocular rosacea can take place. Usually, individuals of the age-group 50 to 60 get affected by this disease.
People who are prone to flushing and blushing are at higher risk for this eye disease. Ocular rosacea is called type IV rosacea as well.(2)
OTC Eye Drops/Creams For Ocular Rosacea
The first important step in the treatment of rosacea is to avoid triggering factors (e.g. environmental influences). Further therapy consists of a combination of different measures. This includes cleaning the eyelids, giving antibiotics and anti-inflammatory drugs and administering moisturizing drops or tear substitutes.
Effective rosacea treatment requires proactive patients willing to take the time to control their condition. When rosacea is present in the eye, the treatment usually consists of eyelid hygiene, including daily cleaning:
The moist Q-tip removes debris of the skin or eyelashes and oily secretions.
Some ophthalmologists recommend using diluted baby shampoo for cleaning, while others believe that pure water is the best.
Generally, antibiotics or antibiotic-steroid combination ointments are prescribed at different times depending on the response. For example, tetracycline tends to act on rosacea, not only due to antibiotic action but also because it tends to decrease the naturally secreted oil viscosity, thus decreasing the “clogging” of the oil glands due to the disease.(3)(4)
Most ophthalmologists prescribe long-acting tetracycline, such as doxycycline, taken once or twice a day. In addition, unlike traditional tetracycline, doxycycline can be taken with food and dairy products without preventing its absorption in the body. Some treatment processes used azithromycin as well.(5)
Causes Of Ocular Rosacea
Similar to skin rosacea, the immediate cause of ocular rosacea is currently unknown. Eye rosacea may be related to one or more of the following factors:
- Environmental factor
- Bacterial infection
- Eyelash mites
- Eyelid glands obstructed
There are also factors that may increase the chance of rosacea on the eyes. These triggers include:
- Alcoholic beverages
- Certain drugs (such as cortisone creams and drugs that dilate blood vessels)
- Hard work or exercises
- Hot drink
- Sauna or hot tub
- Some emotions (such as anger, tension or stress)
- Spicy food
- Strong sunlight, wind or temperature fluctuations
The Manifestation Of Ocular Rosacea
With rosacea of the eyes, different areas can be affected, which can lead to inflammation of the connective tissue, vein or cornea. Other changes can affect the eyelids in particular and result from the blockage of the so-called meibomian glands.
Typical symptoms of ocular rosacea are:
- Burning eyes
- crusty, scaly eyelids
- Dry eyes
- Foreign body sensation inside the eye
- Redness of the edges of the eyelids
- Watery eyes
The symptoms mentioned can also occur with a number of other eye diseases, for example, red-eye with conjunctivitis. This underlines the importance of an ophthalmological examination to make the exact diagnosis and to be able to treat it accordingly.
Diagnosis Of Ocular Rosacea
During the examination with the so-called slit lamp, the ophthalmologist observes typical changes, such as reddened conjunctiva, crusted eyelid margins, clouding of the secretion of the meibomian glands or a foamy tear film.
Rosacea is a skin disease that, depending on the course and shape, may affect the eyes. Red-Eye can be an indication of ocular rosacea, as can crust eyelid margins or sensitive, burning eyes. As a rule, rosacea of the eyes can be managed well and long-term complications can be avoided with early therapy.(1)
- Vieira ACC, Höfling-Lima AL, Mannis MJ. Ocular rosacea: a review. Arquivos brasileiros de oftalmologia. 2012;75(5):363-369.
- Vieira AC, Mannis MJ. Ocular rosacea: common and commonly missed. Journal of the American Academy of Dermatology. 2013;69(6):S36-S41.
- Arman A, Demirseren DD, Takmaz T. Treatment of ocular rosacea: comparative study of topical cyclosporine and oral doxycycline. International journal of ophthalmology. 2015;8(3):544.
- Pfeffer I, Borelli C, Zierhut M, Schaller M. Treatment of ocular rosacea with 40 mg doxycycline in a slow release form. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2011;9(11):904-907.
- Mantelli F, Di Zazzo A, Sacchetti M, Dianzani C, Lambiase A, Bonini S. Topical azithromycin as a novel treatment for ocular rosacea. Ocular immunology and inflammation. 2013;21(5):371-377.