|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.
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
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.
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