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...

Contact allergy in patients with rosacea: a clinic-based, prospective epidemiological study.

Related Articles

Contact allergy in patients with rosacea: a clinic-based, prospective epidemiological study.

J Eur Acad Dermatol Venereol. 2008 Apr 29;

Authors: Jappe U, Schäfer T, Schnuch A, Uter W

Background Rosacea is a relatively common inflammatory skin disease of unknown prevalence. The proportion of contact allergy complicating rosacea and its therapy, respectively, is largely unknown. Objective To estimate the prevalence of specific contact allergy in rosacea patients and to compare this with the prevalence observed in the general population and in general patch test patients. Patients/methods In this prospective monocentre study, 78 patients with rosacea were investigated for contact sensitizations via patch testing the standard series, constituents of topical formulations, preservatives, fragrances, topically applied drugs and, if available, patient's own products. Results Positive reactions occurred to nickel (II) sulphate (12 of 78, 15.4%), fragrance mix I (4 of 77, 5.2%), balsam of Peru (8 of 77, 10.4%; significantly elevated prevalence compared to that observed in the population-based KORA study), potassium dichromate (4 of 78, 5.1%) and Lyral (3 of 78, 3.8%). Regarding topical antibiotics, only 1 of 78 (1.3%) patients was positive to neomycin sulphate, and none to metronidazole; however, 6 of 75 (8%) patients were positive to gentamicin sulphate, and 4 of 76 (5.3%) patients were positive to framycetin sulphate. No allergic but irritant patch test reactions, instead, were provoked by various patients' own products as well as by the irritant sodium lauryl sulphate (SLS) even in low concentrations. Conclusion Despite the limited power of the study, a strikingly high prevalence of contact allergy to gentamicin sulphate was observed, which is probably due to antibiotic treatment of rosacea-associated eye symptoms. The reactions to the irritant SLS probably mirror the extreme skin sensitivity in rosacea.

PMID: 18452530 [PubMed - as supplied by publisher]