Rosacea is a skin condition that causes redness of the face and bumpy skin lesions, and it is relatively common in the US. It can also be a significant risk factor for dry eye disease. Many people who suffer from rosacea also experience inflamed eyelids, Meibomian gland dysfunction, and moderate to severe dry eyes. When these symptoms are caused by the underlying skin condition, they are referred to as ocular rosacea. Ocular rosacea can be difficult to diagnose and effectively treat, so it is important to know the risk factors and warning signs.
What is Rosacea?
Rosacea is not an ocular condition, it is a skin condition, and it must be diagnosed, treated, and managed by a dermatologist. It causes chronic symptoms that most commonly includes facial redness, and may also include highly visible blood vessels (also known as telangiectasia), pus-filled bumps on the facial skin, and even a large bulbous appearance to the nose. The exact underlying cause of rosacea is still unknown, but doctors do know that certain triggers can be responsible for flare-ups or worsening of symptoms. Common triggers include stress, sun exposure or warm temperatures, exercise, certain foods (especially spicy cuisine), alcohol, or even some medications or lotions. Avoiding triggers is an important aspect of living with rosacea. It can also be controlled with topical or prescription medications.
How does Rosacea Cause Dry Eyes?
Rosacea results in chronic inflammation of the eyelids and surrounding tissue. As we know, the eyelids play a pivotal role in the health of the ocular surface. When rosacea results in inflamed eyelids, it can cause additional eye problems like blepharitis and Meibomian gland dysfunction. Both of these eyelid conditions cause or worsen symptoms of dry eye disease. Those who are affected by ocular rosacea are more likely to suffer from dry eyes, and typically experience a more severe degree of dry eye symptoms. Some people affected by rosacea will have red and puffy eyelids, but for others the condition is much less noticeable. At a routine eye examination, your doctor can closely review your medical history and the health of your eyes to see if an underlying condition, such as rosacea, is causing or worsening your symptoms of dry eye disease.
How is Ocular Rosacea Treated?
Treating ocular rosacea is a long-term process. The most important aspect of controlling the symptoms is to manage the underlying eyelid inflammation. This includes lifestyle modifications like avoiding triggers and taking any medications that are recommended by your dermatologist. It also requires ocular treatments like lid scrubs to keep the eyelids free of bacteria and debris. In many cases of ocular rosacea, prescription medications will be recommended to reduce eye inflammation and improve comfort. This can include topical ointments, eye drops, or oral medications. If you suffer from ocular rosacea, it is likely that you will need to work closely with both your dermatologist and your optometrist in order to control inflammation, improve ocular health, and reduce uncomfortable symptoms of dry eye disease.