Ocular Rosacea

Reddish skin often associated with bloodshot eyes are common presentations of ocular rosacea. Image courtesy National Rosacea Society.

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.

Neurovascular Disorder

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.

Symptoms

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.

Treatments

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.

Similar Malady

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.

Looking For Best Lasik Surgeon?

If you are ready to choose a doctor to be evaluated for conventional or custom wavefront Lasik, Bladeless Lasik, PRK, or any refractive surgery procedure, we recommend you consider a doctor who has been evaluated and certified by the USAEyes nonprofit organization. Locate a USAEyes Evaluated & Certified Lasik Doctor.

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Recent Ocular Rosacea Medical Journal Articles...

Related Articles

Ultraviolet radiation-induced upregulation of antimicrobial proteins in health and disease.

Photochem Photobiol Sci. 2013 Jan;12(1):29-36

Authors: Felton S, Navid F, Schwarz A, Schwarz T, Gläser R, Rhodes LE

Abstract
This article reviews recent data on the expression, regulation and activation of antimicrobial peptides (AMP) in human skin, and considers their potential protective and pro-inflammatory roles following upregulation by ultraviolet radiation (UVR). Antimicrobial peptides are small peptides that are key components of the innate immune system, originally identified by their vital role in protecting the body-environment interface from infection. However, it has now become clear that AMP have more extensive actions, including the provision of pivotal links with the adaptive immune system. Moreover, aberrant AMP expression may contribute to immuno-modulated inflammatory dermatoses including psoriasis, eczema and the photoaggravated condition lupus erythematosus. Recent work has demonstrated the direct upregulation of AMP in healthy skin by cutaneous UVR exposure. This may serve to protect the skin from risks imposed by both the biophysical barrier-compromise and the immunosuppression that are attributable to UVR exposure. Furthermore, it is observed that UVR provokes upregulation of AMP in an atypical manner in the photosensitivity disorder polymorphic light eruption. Dysregulated UVR responses of these pro-inflammatory proteins may play a role in the pathogenesis of certain immune-mediated diseases caused or aggravated by sunlight.

PMID: 22945598 [PubMed - indexed for MEDLINE]