Ocular Rosacea

Overview

Ocular rosacea is associated with a chronic skin condition known as rosacea or acne rosacea. This common problem usually affects those with light skin and in the early stages is characterized by redness and bumps concentrated on the forehead nose and cheeks. One of the earliest symptoms of rosacea often experienced during puberty is facial flushing. Flushing for any reason is liable to bring on an attack of redness and pimples. Even people who are being treated for rosacea can relapse if they flush. The following triggers can set it off:

• strong emotional reactions,like embarrassment or anger
• hot drinks
• alcoholic beverages
• stress
• sunlight
• extreme hot and cold temperatures
• vigourous exercise
• menopause
• some medications

Eventually the skin may become chronically red irritated and inflamed. The most severe cases go on to develop rhinophyma the thickening of the skin and connective tissues of the nose often resulting in some facial scarring. Women are affected more often than men but men tend to have more severe symptoms

Approximately 60% of patients with rosacea develop ocular rosacea. These patients most commonly experience irritation of the lids and eye occurring when the oil-producing glands of the lids become obstructed. Styes blepharitis dry eye and chronically bloodshot eyes are also typical conditions. Sometimes scales and crusts can form on the eyelids; there may also be sensitivity to light or blurry vision. In severe ocular rosacea there may be corneal ulceration which if untreated may even lead to corneal scarring. This is a potentially blinding complication.

Detection and Diagnosis

Ocular rosacea is diagnosed by an overall examination of both the facial skin and eyes. Eye care practitioners also frequently use a biomicroscope which allows the detection of tiny visible blood vessels along the eyelid edge and any plugging of the Meibomian glands – both signs of ocular rosacea. Those with rosacea are frequently under the care of a dermatologist and are referred for treatment to an eye care professional when the patient develops related eye conditions.

Treatment

Patients with this condition should avoid hot drinks spicy foods alcohol or activities that cause body temperature elevation. Care should be taken to protect the skin from UV exposure by using sunscreen with a high SPF factor and wearing hats and sunglasses. Controlling skin inflammation may give marked relief of the eye conditions. Because of this the eye care practitioner and dermatologist often work in tandem to treat the problem. Eye-related symptoms can often be relieved with warm compresses on the lids eyelid scrubs and artificial tears. In severe cases topical and/or oral antibiotics may also be prescribed to reduce symptoms. Tetracyclines are very useful in the management of patients with rosacea not only because of the antibiotic effect but because tetracyclines tend to decrease the thickness of naturally secreted oils thereby reducing the amount of oil produced by the glands. Treatment of rosacea is painstaking and often time-consuming.