Ocular Rosacea

Ocular rosacea (pronounced rose-ay-shah) is a contraindication for all refractive surgery techniques until treated and managed. Even after management, having refractive surgery with ocular rosacea may not be wise because of the possibility of reoccurring outbreaks.

Rosacea is a potentially progressive neurovascular disorder that can present as a combination of skin symptoms including redness of the face, flushing, the presence of small blood vessels ("broken" blood vessels), acne, occasional surface irregularities of the nose (called rhinophyma), and symptoms of redness. Rosacea blood vessels undergo changes in function and become hyper-responsive to internal and external stimuli. These changes are ultimately responsible for the progression of all rosacea symptoms. When it affects the eyes it is called ocular rosacea.

Ocular rosacea can affect both the eye surface and eyelid. Symptoms can include redness, dry eyes, foreign body sensations, sensitivity of the eye surface, burning sensations and eyelid symptoms such as styes, redness, crusting and loss of eyelashes. Ocular rosacea can leave the eyes feeling irritated and "gritty".

Many who have rosacea mistakenly think they have allergies.

Use of prescription steroid based eye drops will usually help improve this condition. More severe cases may require oral tetracycline or minocin. Rosacea is more common in individuals with fair complexions, with women affected at a higher rate than men. Patients who are from ethnic backgrounds such as Great Britain (including Ireland, Scotland and Wales), Germany and Scandinavia tend to be more likely candidates, although anyone can develop rosacea. This disease typically develops anywhere between the ages of 30-50. What causes rosacea is still unknown. We do know that the skin form of rosacea is more common in patients who had significant acne earlier in life or have a family history of rosacea.

Seborrheic dermatitis and rosacea are closely related, they both involve inflammation of the oil glands. Rosacea also involves a vascular component causing flushing and broken blood vessels. Seborrheic dermatitis may involve the presence of somewhat greasy flaking involving the area composed of the forehead, nose and around the mouth, crusts, scales, itching and occasionally burning, and may also be found on the scalp, ears and torso. It does not usually involve red bumps as in Rosacea.

Just to confuse things further, the two conditions are often seen together.

A "cure" in the traditional sense is not readily available, however symptoms can normally be reduced to a manageable level. There are plenty of treatment options. An evaluation by an ophthalmologist and/or dermatologist is advised.

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, All-Laser Lasik, PRK, LASEK, Epi-Lasik, NearVision CK, RLE, or any refractive surgery procedure, we highly recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Laser Eye Surgery Doctor.

If this article did not fully answer your questions, use our free Ask Lasik Expert patient forum.

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Current Ocular Rosacea Medical Journal News...

Comparison of the two techniques for measurement of the density of Demodex folliculorum: standardized skin surface biopsy and direct microscopic examination.

Related Articles

Comparison of the two techniques for measurement of the density of Demodex folliculorum: standardized skin surface biopsy and direct microscopic examination.

Br J Dermatol. 2010 Feb 25;

Authors: Aşkın U, Seçkin D

Summary Background In daily dermatological practice, many dermatologists do not include demodicosis in their differential diagnoses, or the diagnosis of demodicosis is frequently masked by other skin diseases such as papulopustular or erythematotelangiectatic rosacea, seborrhoeic dermatitis, perioral dermatitis and contact dermatitis. There are two methods for measurement of the density of Demodex folliculorum (Dd): standardized skin surface biopsy (SSSB) and direct microscopic examination of fresh secretions from sebaceous glands (DME). No study has been reported in the literature comparing the diagnostic value of these two techniques. Objectives To compare the value of the two techniques, SSSB and DME, for the measurement of Dd in patients with suspected demodicosis. Methods Mite density was investigated using SSSB and DME in 37 patients with facial skin lesions suggesting demodicosis. Two samples, one for SSSB and one for DME, were obtained from a cheek lesion of each patient. Results Twenty-three (62%) patients were diagnosed with demodicosis according to their clinical manifestations combined with a high Dd (Dd > 5 mites cm(-2)) with SSSB and/or DME. In all the patients, the mean Dd measured with SSSB was higher than that with DME (22.9 +/- 5.9 and 2.2 +/- 0.8, respectively; P = 0.001). Also, among the 23 patients with demodicosis, the mean Dd measured using SSSB was higher than the mean Dd with DME (36.5 +/- 8.3 and 3.4 +/- 1.2, respectively; P = 0.0001). Conclusions We recommend the use of SSSB for the measurement of Dd as more patients with demodicosis can be diagnosed with this method compared with the DME method.

PMID: 20199545 [PubMed - as supplied by publisher]