What is Ocular Rosacea?
You may have heard of rosacea, a skin disease that causes redness and acne-like bumps on your face. It can affect your eyes, too.
When it does, it’s called ocular rosacea.
It often develops in people who have rosacea, a chronic skin condition that affects the face.
Ocular rosacea is a form of rosacea which causes the eyes red and watery eyes feeling dry and sensitive.
It affects most people with rosacea, although not all.
Ocular rosacea is less frequently found.
5.46% of adults live with Rosacea.
Since most people do not associate eye discomfort with a skin disorder and the symptoms are usually mild, many rosacea patients may not recognize that they suffer from the ocular as well as the facial manifestations of the disorder.
Severe ocular rosacea, however, can pose significant consequences if left untreated, including corneal damage and the development of additional blood vessels in the cornea, a condition known as corneal neovascularization.
Both conditions may result in reduced visual acuity.
Causes
The exact cause of ocular rosacea, like skin rosacea, is unknown.
It may be due to one or more factors, including:
- Heredity
- Environmental factors
- Bacterial involvement
- Blocked glands in the eyelids – meibomian gland dysfunction
- Eyelash mites – demodex
What causes ocular rosacea?
Like skin rosacea, the direct cause of ocular rosacea isn’t well known.
One or more of the following might be a trigger:
- Bacteria
- Blocked eyelid glands
- Environmental factors
- Eyelash mites
- Genetics
Meibomian Gland Dysfunction
Researchers say that 85% of people with ocular rosacea have blocked their oil glands around their eyeslid.
The resulting blockage can cause swells and irritation.
It can cause red and itchy eyes and crusty eyes.
Demodex
Several researchers say mites — tiny spider-like insects living under the hairs follicle of a person’s brows — may block the glands of their hairs.
Common believes
The reason behind Rosacea is unknown by most doctors.
Possibly inherited genetically.
It might happen due to something in your surroundings.
Several people believe rosacea has an effect on swollen blood vessels.
It causes reddish skin and watery flushings.
Some think small insects and bacteria block the oil glands around the face.
This causes swelling and redness.
Other studies have suggested that rosacea can have an association to helicobacter Pylori bacteria. These bacteria cause gastrointestinal problems.
Who is affected?
Adults between the ages of 30 and 50 are the most commonly affected by ocular rosacea.
People who blush or become flushed easily appear to be more prone to the condition than people who don’t.
Some people have rosacea affecting their skin but no symptoms of ocular rosacea.
Others have ocular rosacea but no skin symptoms.
You can also have both forms of rosacea.
Women are more likely than men to have rosacea.
In 15% Trusted Source of all rosacea cases, ocular rosacea occurs first, causing eye symptoms before affecting the face.
But people can also have ocular rosacea on its own without skin symptoms.
People of all ages may develop ocular rosacea, although doctors most commonly diagnose it after age 30 years and usually between ages 40–59 years.
Females are more likely than males to have rosacea, although this may be reflective of females being more likely to seek health advice.
Symptoms
Ocular rosacea symptoms often caused by red eye itching, irritation or swollen eyelids.
It can be painful to have your face burned or swollen.
You could think that sand was everywhere.
Cold air is enough to create watery eyes.
It can cause spots to appear around eyes.
Ocular rosacea can cause eye irritations and make the eyes blurred.
If your symptoms are obvious, see a dermatologist immediately.
Ocular rosacea affect up to 60 percent of rosacea patients in surveys by the National Rosacea Society (NRS), it often results in a watery or bloodshot appearance, irritation and burning or stinging of the eyes.
In addition, the eyelids may become swollen, and styes are common.
Many people report feeling a gritty sensation, as if there’s a foreign body in their eyes.
Blasts of cold air in winter may also trigger worse symptoms.
Recurrent eye or eyelid infections, such as pink eye (conjunctivitis), blepharitis, sties or chalazia.
The severity of ocular rosacea symptoms doesn’t always match the severity of skin symptoms.
Keratitis
Cornea An inflamed cornea (keratitis) is a rare but serious ocular complication of rosacea and can threaten vision.
Keratitis may affect one or both eyes.
The thinned cornea becomes inflamed with superficial punctate erosions , increased blood vessels and opacities.
Keratitis due to ocular rosacea tends to begin at one edge or the bottom of the eye and then spread to affect lower half to two-thirds of the cornea.
Recurrent attacks lead to corneal thinning, increased corneal opacity and vessel invasion.
How is ocular rosacea diagnosed?
Sometimes doctors have used microscopes to find small veins around eyes or glands that could have been damaged.
Ocular rosacea may be suspected in a patient with cutaneous rosacea that has eyelid or eye disease.
The symptoms and signs are nonspecific, so the diagnosis is more difficult in the absence of cutaneous rosacea.
Blepharitis can also be due to seborrhoeic dermatitis , a scaly skin condition, and no one knows for sure what causes rosacea.
Treatment
While there is no cure for rosacea, eye doctor can help control and treat its symptoms.
Here are some treatments for eye symptoms:
- Steroid eye drops and ointments to reduce redness and swelling
- Antibiotic pills or ointments to treat eye infection and rosacea of the skin
- Artificial tears to treat dry eyes
But in almost 58% Trusted Source of cases, ocular rosacea is linked to skin rosacea.
Some of the factors that may contribute to ocular rosacea include : Bacteria: Ocular rosacea can sometimes improve with antibiotics.
Home remedies
At home you can use:
- Applying warm compresses
- Cleansing with a gentle, eye cleanser
- Using eye drops and eye medication
Some patients need to take an antibiotic.
Your dermatologist may also refer you to an ophthalmologist for a check-up or further treatment.
This is more likely if you have moderate or severe ocular rosacea.
Follow your treatment plan.
When rosacea affects your eyes, it’s important to follow your treatment plan.
You may need to wash your eyelids several times a day and use eye medication.
This can seem tedious, but it’s essential to treat your eyes as often as directed.
Prevent flare ups
What causes ocular rosacea flare-ups?
Ocular rosacea flare-ups can be triggered by a variety of factors, it is important to be aware of these to avoid them.
Certain foods and activities can cause rosacea to flare up.
Rosacea triggers you might try to avoid include:
- being outside in the heat, sun, wind, or cold doing very active sports, such as running.
- drinking alcohol
- eating spicy foods
- drinking hot coffee or tea
- feeling stressed or upset
Ocular rosacea treatment complications
The biggest complication of ocular rosacea treatment is that your symptoms get so bad they affect your eyes and vision permanently.
There’s also a risk that touching your eyes can lead to infections.
When to see a doctor?
Make an appointment to see a doctor if you have signs and symptoms of ocular rosacea, such as dry eyes, burning or itchy eyes, redness, or blurred vision.
If you’ve been diagnosed with skin rosacea, ask your doctor whether you should undergo periodic eye exams to check for ocular rosacea.
Your healthcare provider will diagnose ocular rosacea with a physical exam.
Make sure you tell them about all the symptoms you’ve felt, even if they get better before your appointment.
Your symptoms, medical history and whether you’ve noticed any triggers are the only way to diagnose.
References
Show Sources SOURCES: University of Texas Health Science Center: “Ocular Rosacea.”
National Rosacea Society: “Frequently Asked Questions,” “Ocular Rosacea Can Threaten Sight,” “Researchers Make Advances in Understanding of Ocular Rosacea,” “What Your Eyes Might Be Telling You.
Vieira AC and Mannis MJ. “Ocular rosacea: Common and commonly missed.” J Am Acad Dermatol . 2013;69:S36-41.
Webster G, Schaller M. “Ocular rosacea: A dermatologic perspective.” J Am Acad Dermatol . 2013;69(6 Suppl 1):S42-3.
