Ocular rosacea is an inflammation of the eyes, associated with the dermatological condition known as rosacea. Rosacea affects parts such as the face and chest. When it occurs on the skin, the condition can often be confused with acne.
According to reports, about 60% of those with skin rosacea develop the ocular form. However, those with ocular rosacea may not necessarily have the skin symptoms. Ocular rosacea is an incurable disorder that can lead to visual impairments if not treated.
Causes and Risk Factors
As with the skin rosacea, the etiology of ocular rosacea is not clear. However, it is believed to occur due to either of the following causes:
- Genetics – Some researchers believe ocular rosacea to be a genetic disorder that is passed down to others.
- Bacteria – Helicobacter pylori, the bacteria responsible for some gastrointestinal infections has also been linked to rosacea of the eyes.
- Meibomian gland dysfunction – The meibomian glands line the edges of the eyelids. They secrete fatty substances which stabilize the tear film. The meibomian gland dysfunction is a disorder in which the glands are blocked. It is seen in about 85% of individuals with ocular rosacea.
- Mites and other organisms – Researches have linked mites and other small organisms with ocular rosacea. The organisms are said to cause blockage of the oil lands.
The disorder can also be triggered by factors such as:
- Caffeinated beverages
- Hot, spicy foods
- Strenuous exercises
- Extreme temperatures
- Certain drugs
- Ocular rosacea is more apparent in adults between the age of 30 and 50. It affects women more than men.
Signs & Symptoms
The signs and symptoms that accompany ocular rosacea are as follows:
- Blepharitis/ inflammation of the eyelids
- Dry eyes
- Foreign body sensation
- Itchiness and stinginess of the eyes
- Redness and excess watering
- Dilated small blood vessels (telangiectasia)
- Light sensitivity
- Blurry vision
Styes are also common in people with rosacea.
Usually, the eye care professional takes no specific tests. A simple clinical examination of the eyes and medical history of the patient may be enough for diagnosis. In some instances, however, a slit lamp exam may be necessary. The device is used to magnify the eyes in order to see the inside. In patients with ocular rosacea, the test may show telangiectasia on the eyelid margin. The blocked oil glands can also be detected.
Treatment focuses on alleviating symptoms and minimizing/ correcting damage.
The eye doctor may prescribe a few drugs to ease some symptoms. These can include:
- Antibiotic drops/Antibiotic and steroid combination drops – The drugs are prescribed for varying periods of time. The antibiotics prevent growth of bacteria whereas the steroids reduce inflammation.
- Artificial tears – These are lubricating drops that act as the normal tears in the eye. They treat dry eye symptoms by keeping the ocular surface moist.
- Tetracycline derivatives – Doxycycline is an example of a tetracycline that is prescribed in patients with ocular rosacea. The drug assists in reducing the plugging in the oil glands.
Probing is a newer form of treatment for ocular rosacea. It involves placement of thin rods into the plugged meibomian glands to open them up. Another surgical procedure is the insertion of punctal plugs for closure of the year drainage ducts. The plugs help prevent leakage and keep the eye moist. In a few instances, punctal cautery may be performed. This is where the tear duct openings are sealed through burning.
Doctors recommend supplementation with omega-3 fatty acids for ocular rosacea. Omega-3 fatty acids are said to stabilize the meibomian glands. They should however be taken with supervision. Those taking blood-thinning medications such as aspirin are cautioned against the supplements.
Warm compresses should be applied regularly on the eyelids to help unclog the glands. Lid hygiene should also be practiced. The hygiene involves using moistened Q-tips to remove oil, dirt and debris from the eyes. A mild cleanser such as diluted baby shampoo can also be used to wash the eye region.
Ocular rosacea is not curable. However, treatment minimizes damage and aids in easing symptoms. When it is delayed, the rosacea may affect the cornea. The corneal complications can include inflammation, ulceration, scarring and neovascularization. Patients risk severe visual impairments with these complications.
Individuals with ocular rosacea should avoid triggers such as drinking alcohol, stressful environments, harsh weather, caffeine, and spicy foods. Going for regular eye exams is also important in early detection and treatment.