one in twenty American sufferers, Acne Rosacea is one of the most
frequently seen long-term skin disorders.
Typically appearing between the ages of 30 and 50 and affecting
more women than men, it is characterized by patchy redness
(flushing) and inflammation around the mouth, cheeks, nose, and
Pus-filled pimples cause these facial symptoms and small, red
inflammatory bumps on the surface of the skin along with hundreds of
tiny dilated blood vessels just underneath.
As well as the skin effects, around 50 to 60% of Rosacea
sufferers also have varying degrees of eye inflammation. This
problem, known as ocular Rosacea, can sometimes occur even before
the skin symptoms, but more often the skin changes appear first.
Among the commonest signs of ocular Rosacea are scaly, inflamed
eyelid margins but they can range from mild dry eye symptoms all the
way up to sight threatening iritis and keratitis.
Dry eyes: The first sign of ocular Rosacea is usually a
persistent gritty burning feeling with the eyes and lid margins
becoming bloodshot. Sufferers become more sensitive to sunlight
(photophobia) and usually require dark sunglasses even on the
mildest of sunny days. Rosacea reduces tear lubrication by affecting
the meibomium glands in the eyelids.
The special oils they produce lubricate the eyes and help stop
tears evaporating too quickly. As tears are vital in keeping the
front of the eye healthy any abnormal or decreased oil secretions
not only produce the dry eye symptoms but also make eyes susceptible
to further inflammation and infection. Rapid early treatment of
Rosacea dry eye helps avoid long-term inflammation as well improving
Blepharitis: As the tear film and meibomium gland damage persist
they produce an inflammatory lid response known as Rosacea
blepharitis. The lid margins become inflamed and crusted and over
time they become thickened, often with loss of eyelashes and
The inflammation can also extend to the outer eye causing the
bloodshot pink eye often seen in conjunctivitis. Blepharitis
symptoms can be managed by basic hygiene measures such as lid scrubs
and warm compresses but the best treatment is to deal with the
Keratitis & Iritis: Although rare, these are two of the more
sight threatening complications seen in ocular Rosacea. Keratitis is
inflammation of the clear window at the front of the eye (cornea)
and urgent treatment is needed to avoid vision-impairing scars.
Symptoms involve blurry vision, sensitivity to light and often
severe eye pain.
As the iris (the tissue that gives us our eye color) is inside
the eye, iris inflammation can quickly produce marked pain and
irreparable damage. To prevent permanent vision loss, both iritis
and keratitis are often rapidly treated with high dose topical
As ocular Rosacea is a secondary condition it can’t be “cured”
but it can be managed by treating the underlying Rosacea. Improving
hydration by drinking extra water and avoiding dehydrating
stimulants such as alcohol and coffee are lifestyle changes known to
help avoid minor Rosacea discomfort.
Long-term antibiotic treatments are often needed for moderate to
severe Rosacea although laser skin resurfacing treatments may be
helpful in some cases. Oral antibiotics such as doxycycline and
topical antibiotics such as metronidazole are the mainstay of
effective Rosacea treatment but may take several months to show
improvement in the ocular Rosacea.
Ocular Rosacea is unfortunately a chronic problem that needs
constant attention and persistence. Although long-term oral
antibiotics do help, prompt local treatment is vital when an attack
occurs. Major flare-ups may need topical cortisone and antibiotics
to control them but that need should be rare.
With lid scrubs to clean up lashes and eyelids and lubricants to
subdue dry eyes, most ocular Rosacea sufferers can be comfortable on
a day-to-day basis. It may be difficult to avoid the red faced look
of acne Rosacea but there is little excuse for suffering the red
eyes of ocular Rosacea.
When following these treatments to control and cure Rosacea, be
sure to adhere strictly to the guidelines prescribed by your doctor
for each one.