Ocular Rosacea and Eye Inflammation

When a stubborn eye irritation and inflammation resists common treatment, ocular rosacea should be suspected.

What is Rosacea?

Rosacea is a disease of the sebaceous glands of the skin. While many people are aware that it causes a mild reddish-colored rash on the nose, cheeks or over the eyebrows, most people are not aware that rosacea is a common cause of eye inflammation and irritation.

Rosacea has several diagnostic signs:

• The redness of the cheeks or nose increases after alcohol.
• The redness increases after spicy foods.
• Patients tend to have a northern European heritage. Irish ancestry is very common.

Rosacea of the skin is usually treated with a cream like Metrogel that is rubbed on two or three times per day.

Members of the tetracycline family such as doxycycline or minocycline are often used in low-dose oral tablets to improve problem cases. The tetracyclines are not used because of their antibiotic properties but because they reduce the formation of inflammatory fatty-acids that occur in the meibomian glands and sebaceous glands of the skin, including the eyelids.

Diagnosis

The eye form of the disease (known as ocular rosacea) often exists with a sub-clinical case of skin rosacea, so the patient is often unaware they have the condition.

The eye form is suspected when evaluation of the eye finds pronounced dilated blood vessels on the margins of the eyelids. Tear film testing with also show a rapid or immediate break-up of the tear film (Break-Up Tear Test).

Symptoms

The eye inflammation produces a scratchy, irritated eye with only mild redness. Vision is usually unaffected. Artificial tears are often being used by the patients I see with inadequate results.

Ocular Rosacea Treatment

Tetracyclines are frequently employed in the ocular form unless the patient has a tetracycline allergy or has a gastro-intestinal reaction to tetracyclines.

Women are also at increased risk for vaginal yeast infections.

We always recommend patients on these medications take two good acidophilus tablets per day to maintain normal intestinal bacterial flora.

Tetracyclines should be taken with lots of water, away from dairy products and should not be taken at bedtime.

Acute Cases

Tetracyclines are often started at the time of diagnosis but take about a month to produce improvement.

The acute form is often additionally treated in the same manner as Dry Eye Syndrome. However, some of my rosacea patients have been unable to take the fish oils due to increased inflammation.

Eye Inflammation and C-Reactive Protein...

Like so many, if not all, of the other diseases we have discussed in this website, rosacea is an inflammatory process.

There is a good test for the overall level of inflammation in the body called a CRP (C-Reactive Protein). Cardiologists are using it more and more to monitor heart disease and rheumatologists have used it for years to monitor autoimmune conditions.

Perhaps someday doctors will routinely use CRP to monitor all diseases and tailor low-animal protein diets for their patients to reduce inflammatory levels.

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