Simply Ocular Rosacea
In all simplicity, ocular rosacea is a combination of dry eye and ocular inflammation. Surprisingly, relieving the dry eye symptoms usually results in substantial improvement of ocular rosacea.
One of the main complaints that ocular rosacea sufferers complain of is blurry vision. In 99% of the cases this actually has nothing to do with vision loss. It has to do with a disturbance in the three layers of moisture on your eye surface (mucus, water and oil).
This(and sometimes the inflammation) plays a role. Good treatment focuses on getting back a normal tear film layer first, then seeing what happens.
ARTIFICIAL TEARS are one of the best things you can do for your eyes.While treatment for ocular rosacea is usually multifactorial, several studies have shown that daily use of artificial tears for three to four months can help the tear film stabilize by decreasing ocular irritation.
Then patients can sometimes stop immediately or just use them upon flare ups. PLEASE DON'T USE VASO-CONSTRICTOR EYEDROPS!
The challenge is to find the right eye drop for your eye. The eye vessels in general are a lot more forgiving then the facial vessels.
Many folks recommend Refresh Plus Drops for Sensitive Eyes or Thera Tears eye drops, which are preservative free.
In many cases, the normal eye drops are not strong enough. That is why the leaders in the industry have made gel drops. Several of these gel drops by themselves have been shown to improve the entire tear film layer, stabilize the water concentration and electrolyte balance, and reduce some forms of inflammation. Gels last 4 to 8 times longer than most normal eye drops.
Some of the newer versions of gel drops worth a try are:
1. GenTeal Eye Gel Carbopol 980 gel. This is the strongest gel drop. For flat out moisturization without blurriness.
2. Bausch and Lomb Liquid Gel Hypromellose gel.
3. Systane hydroxypropyl guar. This is the newest gel derivative and there is quite a bit of information on pubmed about the guaractions.
Many like the Similasan I and II drops. For those with severe dry eye, the Lacriserts placed under the eyelid at night still have no match.
Another good topical for ocular rosacea is an ointment called Lacrilubeby Allergan. It is kind of thick and sticky so you won't really be able to use it during the day. It definitely makes your eyes feel better, especially when they have that foreign body sensation or irritation. You put it directly in the pocket of your eyes.
If the inflammation is still severe, Doxycycline 100 mgs 2 to 4 times a day can be used or Periostat 40 mgs. If this fails, then the mast cell inhibitor Patanol is always a good try.
Two new eye drops/suspensions continue to show promise for moderate to severe ocular rosacea.
1. 10% N-acetylcysteine drops (Mucomyst) -- This mucolyticagent can be used successfully in rosacea patients with abnormal tear film layer (mucus layer). In ocular rosacea, the superficial inflammation can alter goblet cells, which affects the production of the tear film layer. This is the first agent to address this specific problem.
2. Cyclosporine ophthalmic (Restasis) drops -- Used to relieve dry eyes caused by suppressed tear production secondary to ocular inflammation. First eye drop to actually increase natural tear production, stabilize tear film layer and resolve ocular inflammation. Restasis eye drops are available by prescription. It can take up to 3 months to see their full effect.
Oral cyclosporine can cause a number of side effects. Topical cyclosporine (restasis) should be used cautiously in moderate to severe ocular rosacea patients, but it is generally much safer to use. Medical studies indicate it may be used safely long term 6 to 9 months with a low side effect profile. In many patients, it relieves the inflammation and therefore stops the tear film layer from breaking up.
Regarding rosacea, it specifically blocks several classes of inflammatory cytokines on the ocular surface, which this makes the ocular surface more "healthy". If you decide to start the eye drops, follow up with your doctor and get ocular surface testing every 3 to 6 months.
One of the main complaints that ocular rosacea sufferers complain of is blurry vision. In 99% of the cases this actually has nothing to do with vision loss. It has to do with a disturbance in the three layers of moisture on your eye surface (mucus, water and oil).
This(and sometimes the inflammation) plays a role. Good treatment focuses on getting back a normal tear film layer first, then seeing what happens.
ARTIFICIAL TEARS are one of the best things you can do for your eyes.While treatment for ocular rosacea is usually multifactorial, several studies have shown that daily use of artificial tears for three to four months can help the tear film stabilize by decreasing ocular irritation.
Then patients can sometimes stop immediately or just use them upon flare ups. PLEASE DON'T USE VASO-CONSTRICTOR EYEDROPS!
The challenge is to find the right eye drop for your eye. The eye vessels in general are a lot more forgiving then the facial vessels.
Many folks recommend Refresh Plus Drops for Sensitive Eyes or Thera Tears eye drops, which are preservative free.
In many cases, the normal eye drops are not strong enough. That is why the leaders in the industry have made gel drops. Several of these gel drops by themselves have been shown to improve the entire tear film layer, stabilize the water concentration and electrolyte balance, and reduce some forms of inflammation. Gels last 4 to 8 times longer than most normal eye drops.
Some of the newer versions of gel drops worth a try are:
1. GenTeal Eye Gel Carbopol 980 gel. This is the strongest gel drop. For flat out moisturization without blurriness.
2. Bausch and Lomb Liquid Gel Hypromellose gel.
3. Systane hydroxypropyl guar. This is the newest gel derivative and there is quite a bit of information on pubmed about the guaractions.
Many like the Similasan I and II drops. For those with severe dry eye, the Lacriserts placed under the eyelid at night still have no match.
Another good topical for ocular rosacea is an ointment called Lacrilubeby Allergan. It is kind of thick and sticky so you won't really be able to use it during the day. It definitely makes your eyes feel better, especially when they have that foreign body sensation or irritation. You put it directly in the pocket of your eyes.
If the inflammation is still severe, Doxycycline 100 mgs 2 to 4 times a day can be used or Periostat 40 mgs. If this fails, then the mast cell inhibitor Patanol is always a good try.
Two new eye drops/suspensions continue to show promise for moderate to severe ocular rosacea.
1. 10% N-acetylcysteine drops (Mucomyst) -- This mucolyticagent can be used successfully in rosacea patients with abnormal tear film layer (mucus layer). In ocular rosacea, the superficial inflammation can alter goblet cells, which affects the production of the tear film layer. This is the first agent to address this specific problem.
2. Cyclosporine ophthalmic (Restasis) drops -- Used to relieve dry eyes caused by suppressed tear production secondary to ocular inflammation. First eye drop to actually increase natural tear production, stabilize tear film layer and resolve ocular inflammation. Restasis eye drops are available by prescription. It can take up to 3 months to see their full effect.
Oral cyclosporine can cause a number of side effects. Topical cyclosporine (restasis) should be used cautiously in moderate to severe ocular rosacea patients, but it is generally much safer to use. Medical studies indicate it may be used safely long term 6 to 9 months with a low side effect profile. In many patients, it relieves the inflammation and therefore stops the tear film layer from breaking up.
Regarding rosacea, it specifically blocks several classes of inflammatory cytokines on the ocular surface, which this makes the ocular surface more "healthy". If you decide to start the eye drops, follow up with your doctor and get ocular surface testing every 3 to 6 months.
posted by Nick Riley at 8:15 AM
<< Home