Ocular rosacea is associated with a chronic skin condition known as acne rosacea. The problem usually affects those with light skin, and is characterized by redness and bumps concentrated on the forehead, nose and cheeks. One of the earliest symptoms of rosacea (often experienced during puberty) is facial flushing brought on by changes in body temperature, emotion, or hot drinks. Eventually, the skin may become chronically red, irritated and inflamed.

Approximately 60% of patients with rosacea develop related problems affecting the eye (ocular rosacea). Patients with ocular rosacea most commonly experience irritation of the lids and eye, occurring when the oil-producing glands of the lids become obstructed. Styes, blepharitis, episcleritis, and chronically red eyes are also typical conditions. Ocular rosacea may also affect the cornea, causing neovascularization (abnormal blood vessel growth), infections, and occasionally ulcers.

Signs and Symptoms

Acne Rosacea

• Red, flushed skin
• Breakouts or papules concentrated on the nose, forehead, and cheeks
• Facial flushing after drinking alcohol, eating hot or spicy foods, or events that increase body temperature
• Dry, flaking skin

Ocular Rosacea

• Chronically red eyes and lid margins
• Irritated eyelids (blepharitis)
• Styes (chalazion)
• Dry, irritated eyes
• Burning
• Foreign body sensation

Detection and Diagnosis

Those with ocular rosacea are frequently under the care of a dermatologist and are referred for treatment when the patient develops related eye conditions. However, the eye care practitioner may also make the initial diagnosis with a routine eye exam and evaluation of the skin.

Treatment

Patients with this condition should avoid hot drinks, spicy foods, alcohol, or activities that cause the body temperature to become elevated. Care should be taken to protect the skin from ultraviolet light exposure by using sunscreen with a high SPF factor and wearing hats and sunglasses when outdoors.

Controlling skin inflammation may give marked relief of the eye conditions. Because of this, the eye care practitioner and dermatologist often work together to treat the problem. Eye-related symptoms can often be relieved with warm (not hot) compresses on the lids, eyelid scrubs and artificial tears. Topical and/or oral antibiotics may also be prescribed to reduce symptoms.

Illustrations by Mark Erickson
With acknowledgement to St. Lukes Eye Hospital.