A single copy of this article may be reprinted for personal, noncommercial use only.
Ocular rosaceaBy Mayo Clinic staff
Original Article: http://www.mayoclinic.com/health/ocular-rosacea/DS01177
Ocular rosacea (roe-ZAY-she-uh) is inflammation of the eye that occurs as a result of rosacea, a chronic, inflammatory condition that affects the skin on your face, nose and forehead. Many people with skin rosacea develop ocular rosacea, usually in combination with skin symptoms, but occasionally ocular rosacea occurs by itself.
Ocular rosacea primarily affects adults between the ages of 30 and 60. Ocular rosacea is more common in people with fair skin.
If you have skin rosacea, you may not realize that your ocular rosacea symptoms, such as dry eyes, are connected to the condition. There's no cure for ocular rosacea, and left untreated, it tends to get worse. There are medications to help you manage the condition.
Signs and symptoms of ocular rosacea can precede skin symptoms, develop at the same time, develop later or occur on their own. Signs and symptoms of ocular rosacea may include:
- Dry eyes
- Burning or stinging in the eyes
- Itchy eyes
- Grittiness or feeling of having a foreign body in the eye or eyes
- Blurred vision
- Sensitivity to light (photophobia)
- Redness (erythema)
- Visibly dilated small blood vessels on the white part of the eye
- Red, swollen eyelids
The severity of ocular rosacea symptoms don't always match the severity of skin symptoms.
When to see a doctor
Make an appointment to see a doctor if you have 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.
The cause of ocular rosacea, like skin rosacea, is unknown, but it may be due to a combination of hereditary and environmental factors.
A number of factors can aggravate rosacea, so they can aggravate ocular rosacea, as well. Some of these factors include:
- Consuming hot foods or beverages
- Eating spicy foods
- Drinking alcohol
- Being in extreme cold or heat
- Being in sunlight
- Being stressed, angry or embarrassed
- Exercising strenuously
- Taking hot baths or being in hot tubs, steam rooms or saunas
- Taking drugs that dilate blood vessels, including some blood pressure medications
Anyone who has skin rosacea can develop ocular rosacea. Although skin rosacea affects more women than men, ocular rosacea affects men and women equally. Among people who have skin rosacea, there's no way to tell who will develop eye symptoms. However, the development of sties — red, painful lumps near the edge of the eye — may be an early sign of ocular rosacea. Ocular rosacea is common in people with skin rosacea, and you may be more likely to develop skin rosacea if you:
- Have fair or light skin
- Are between the ages of 30 and 60, especially if you're a woman going through menopause
- Are prone to flushing or blushing
- Have a family history of rosacea
Left untreated, ocular rosacea may affect the surface of your eye (cornea), particularly when you have dry eyes from a deficiency of tears. Inflammation of your eyelids (blepharitis) can cause secondary irritation of the cornea from misdirected eyelashes or other complications. Ultimately, these conditions can lead to vision loss.
Preparing for your appointment
If you have signs and symptoms of ocular rosacea, you're likely to first see your primary care doctor. However, in many cases you may be referred immediately to an ophthalmologist.
Here's some information to help you prepare for your appointment.
What you can do
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- If you've been diagnosed with rosacea, be prepared to discuss your treatment history.
- Write down key personal information, including any major stresses or recent life changes.
- Create a list of all medications, vitamins or supplements you're taking.
- Write down questions to ask your doctor.
Preparing a list of questions for your doctor can help you make the most of your time together. List your questions from most important to least important. For ocular rosacea, some basic questions to ask your doctor include:
- What is likely causing my symptoms?
- Other than the most likely cause, what are other possible causes for my symptoms?
- What kinds of tests do I need?
- Is my condition likely temporary or chronic?
- What is the best course of action?
- What are the alternatives to the primary approach you're suggesting?
- I have these other health conditions. How can I best manage them together?
- Are there any restrictions that I need to follow?
- Is there a generic alternative to the medicine you're prescribing?
- Are there any brochures or other printed material that I can take with me? What websites do you recommend?
Don't hesitate to ask any other questions that arise during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, including:
- When did your symptoms begin?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- Have you noticed any changes in your skin, such as redness, bumps or flushing?
- Have you noticed any changes in vision?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
Tests and diagnosis
There are no specific tests or procedures for diagnosing ocular rosacea. Instead, your doctor will likely make a diagnosis by:
- Reviewing your signs and symptoms
- Taking your medical history
- Examining your eyes and eyelids
Treatments and drugs
The goal of therapy for ocular rosacea is to manage the condition. There is no specific cure.
Doctors typically prescribe oral antibiotics, such as tetracycline, doxycycline (Doryx, Oracea, others), erythromycin or minocycline (Dynacin, Minocin, others), for severe ocular rosacea. Rarely, your doctor may also prescribe the temporary use of oral antibiotics or corticosteroids to reduce inflammation. Artificial tears may be helpful to combat the dryness, but some tear preparations designed to alleviate redness can make the redness worse, especially when the drops are discontinued after long-term use.
Lifestyle and home remedies
To manage your ocular rosacea, the following may bring some symptom relief:
- Use artificial tears to relieve dryness. Ask your doctor for guidance.
- Keep your eyelids clean by gently washing them daily with warm water or a product your doctor recommends.
- If you wear contact lenses, you may want to forgo wearing your contacts during flare-ups, especially if your symptoms include dry eyes.
There's no known way to prevent ocular rosacea, but you can take steps to control your symptoms.
- Continue your treatment plan. Even if it clears completely, ocular rosacea is likely to return. Keep taking the medications your doctor prescribes and cleanse your eyelids daily.
- Avoid things that trigger rosacea, if possible. Find out what the triggers are, if any, that worsen your ocular rosacea and take steps to prevent or avoid them. Extreme temperatures, sun exposure, spicy foods, alcohol and stress all can trigger ocular rosacea.
- Rosacea. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Rosacea/default.asp. Accessed May 14, 2012.
- Bron A. Ocular rosacea. http://www.uptodate.com/index. Accessed May 14, 2012.
- Riordan-Eva P, et al. Vaughan & Asbury's General Ophthalmology. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=55781421. Accessed May 14, 2012.
- Webster GF. Rosacea. Medical Clinics of North America. 2009;93:1183.
- Paralejo B, et al. Dermatologic and allergic conditions of the eyelid. Immunology and Allergy Clinics of North America. 2008;28:137.