The Effects of Ocular Rosacea

"The effects of ocular rosacea may easily be overlooked because they often develop after, and sometimes before, the disorder affects the skin," said Dr. Bryan Sires, associate professor and acting chair of ophthalmology at the University of Washington. "In most cases, ocular rosacea is a mild, irritating condition, but it can develop into a permanently debilitating one -- including loss of vision -- without proper care."
Although as many as 58 percent of rosacea patients have been found to have ocular symptoms in clinical studies, he noted that the condition may be easily controlled if diagnosed and treated before it becomes severe.
An eye affected by rosacea often appears to be watery or bloodshot. Patients may feel a gritty or foreign body sensation in the eye, or have a dry, burning or stinging sensation.
Dr. Sires added that in the majority of ocular rosacea patients, beyond mild irritation there is a feeling of fullness in the eyelid. This is often the result of thickened secretions of the meibomian or Zeis glands along the eyelid margin. The fatty secretions help to avoid evaporation of the watery layer of the tears. The plugging of these glands may lead to dry eye or styes, both common manifestations of ocular rosacea.
"Severe symptoms result when the cornea becomes infected," he said. "These patients have a deep boring pain. At this point, an aggressive treatment approach is necessary to avoid the need for a more invasive procedure like corneal transplantation."
Left untreated, patients with severe ocular rosacea could endure scarring within the eyelid, vision loss from corneal ulcers and potential loss of the eye if an ulcer progresses beyond the cornea.
Ocular rosacea is diagnosed by an overall examination of both the facial skin and eyes. Ophthalmologists also frequently use a biomicroscope, which allows the detection of tiny visible blood vessels along the eyelid margin and any plugging of the meibomian glands -- both signs of ocular rosacea.

The Terminology of Ocular Rosacea

Knowing the terminology of rosacea, ocular rosacea and adult acne can helps you to communicate effectively and fully understand your ocular rosacea treatment and medication options. This glossary defines commonly used rosacea terms, including names of products and medications used in the treatment of ocular rosacea and skin conditions that co-exist with rosacea, such as acne, eczema, lupus, and psoriasis.

Treatment of Ocular Rosacea

Ocular rosacea treatment usually consists of lid hygiene measures which include daily cleansing with cotton-tipped applicators (Q-tips). This entails cleansing the bases of the lashes with a moistened Q-tip to remove debris and oily secretions. Some ophthalmologists advocate cleansing with dilute baby shampoo, while others believe that plain water is best.

Often, an antibiotic or combination antibiotic-steroid ointment is prescribed for various periods of time, depending on response. The dry eye syndrome, which often accompanies rosacea, should be treated with non-preserved artificial tears, as often as 4 times a day or more.

A home humidifier may also be valuable.

If these measures are not sufficient, closure of the tear drainage ducts may be easily accomplished with silicone plugs, which are reversible, or punctal cautery (burning of the tear duct openings), which is relatively permanent.

Tetracyclines (e.g., doxycycline) are very useful in the management of patients with rosacea, not only because of the antibiotic effect, but because tetracyclines tend to decrease the viscosity of naturally secreted oils, thereby reducing the oil gland "plugging" that occurs with this disease. Most ophthalmologists will prescribe long-acting tetracyclines such as doxycycline, which can be taken once or twice a day. Furthermore, doxycycline, unlike traditional tetracycline, can be taken with food and milk products, without an adverse effect on absorption.

Protecting Your Eyes In The Summertime

Prolonged exposure to the ultraviolet rays in sunlight can cause serious eye damage. As we head into the summer season, an expert recommends some simple and effective ways to protect your eyes from UV rays.

Durham, N.C. -- As the weather warms up and we spend more time outside, the sun’s ultraviolet rays pose a greater risk, not just to our skin but also to our eyes. Dr. Eric Postel, an associate professor of ophthalmology in the Vitreoretinal Service at Duke University Eye Center, says UV rays may damage eye tissue and cause serious vision problems.

He says the best safeguard is prevention. “Protect yourself from the sun using hats, sunblock and sunglasses. We know that UV light can cause damage and leads to conditions such as cancer and cataracts. The other effects are less well understood, for example macular degeneration, but the simplest thing to do is to try and prevent it.”

Postel recommends sunglasses that block 100 percent of UV light. Wraparound styles can provide additional protection, and any lens color is equally effective. And don’t forget impact-resistant sunglasses for the kids. “The damage you receive from UV light is cumulative. Certainly, children who are outside and playing much more frequently than adults are more susceptible to sun damage, and we’re much more aware of that nowadays than when I was a child.”

Symptoms of Ocular Rosacea

Basic Signs of Ocular Rosacea can include one or more of the following:
~Burning sensations
~Itching of the eye surface
~Redness, crusting, and inflammation of the eyelids. In some cases, crust may form overnight and 'glue' the eyelids together
~Inflammatory bump on the eyelid
~Inflammation of an eyelash follicle
~Excess discharge from the sebaceous glands of the eyelids
~Loss of eyelashes
~Severe damage to the cornea with blindness
~Bloodshot eyes~Hyper-sensitivity of the eye surface
~Foreign body sensations
~Excess tearing
~Eye sensitivity to wind, cold, smoke, indoor heating