Dr Ben Wild
Overview |
The eyelids are made up of various types of skin, muscle, glands, hair follicles and much more. Their purpose is to protect the eyes from dryness, bright lights and irritants.
Frontal view of a healthy eye.
Rosacea is a common chronic skin condition that can affect facial skin by causing blood vessels to become visible, blushing, flushing and pustule formation without blackheads, similar to acne. Rosacea is much more common in Caucasians and usually presents along the forehead and both cheeks from the lower eyelid to below the nose or on other sun exposed areas of the skin. Unfortunately, there is no known cure but treatment can reduce or even control the signs and symptoms.
Ocular rosacea affects 20% of people with rosacea and presents as dilated blood vessels of the eyelids, pustule formation, and blepharitis. Severe rosacea can affect the eye itself, causing various conditions like phlyctenulosis, marginal keratitis, and the growth of blood vessels into the cornea.
Front view of an eye with severe ocular rosacea.
Signs and Symptoms |
Signs
Crusty eyelashes, red eyelids, red eyes, loss of eyelashes, recurrent chalazions (eyelid styes), off white bumps on the conjunctiva, collections of white blood cells in the cornea.
Symptoms
Stinging, burning, gritty, itchy eyes, mild light sensitivity, poor contact lens tolerance (difficulty with contact lens comfort), fluctuating vision.
Causes and Risk Factors |
Causes
There are no know causes of rosacea but skin becomes irritated after hot drinks, spicy foods, alcohol, extreme temperatures, sun, wind, exercise, and skin care products with preservatives.
Risk factors
Female, Caucasian, skin that burns easily, smoking, genetic predisposition.
Prevention and Treatment |
Prevention
Avoid exposure to the causes/risk factors above.
Treatments
1. Artificial tears.
2. Hot compresses and lid massage.
3. Lid hygiene with Blephagel or Cetaphil.
4. Topical antibiotic drops or ointments.
5. Topical steroid drops.
6. Topical cyclosporin drops.
7. Tetracycline pills.
8. Retinoids (although this could make it worse).
9. Intense Pulsed Light (IPL) or radio frequency (RF) treatments.
Prognosis |
Unfortunately, there is usually no cure for rosacea. It can lead to a lifetime of dry eye symptoms that need regular management. Thankfully, in most cases, regular management including artificial tears, lid hygiene and hot compresses will likely be enough. Severe cases can cause corneal scarring which could affect vision and requires frequent follow up exams and more intensive treatment.