Overview

Ocular rosacea (roe-ZAY-she-uh) is inflammation that causes redness, burning and itching of the eyes. It often develops in people who have rosacea, a chronic skin condition that affects the face. Sometimes ocular (eye) rosacea is the first sign that you may later develop the facial type.

Ocular rosacea primarily affects adults between the ages of 30 and 50. It seems to develop in people who tend to blush and flush easily.

There's no cure for ocular rosacea, but medications and a good eye care routine can help control the signs and symptoms.

Symptoms

Signs and symptoms of ocular rosacea can precede the skin symptoms of rosacea, develop at the same time, develop later or occur on their own. Signs and symptoms of ocular rosacea may include:

  • Red, burning, itchy or watering eyes
  • Dry eyes
  • Grittiness or the feeling of having a foreign body in the eye or eyes
  • Blurred vision
  • Sensitivity to light (photophobia)
  • Dilated small blood vessels on the white part of the eye that are visible when you look in a mirror
  • Red, swollen eyelids
  • Recurrent eye or eyelid infections, such as pink eye (conjunctivitis), blepharitis, sties or chalazia

The severity of ocular rosacea symptoms doesn't always match the severity of skin symptoms.

When to see a doctor

Make an appointment to see a doctor if you have signs and symptoms of ocular rosacea, such as dry eyes, burning or itchy eyes, redness, or blurred vision.

If you've been diagnosed with skin rosacea, ask your doctor whether you should undergo periodic eye exams to check for ocular rosacea.

Causes

The exact cause of ocular rosacea, like skin rosacea, is unknown. It may be due to one or more factors, including:

  • Heredity
  • Environmental factors
  • Bacterial involvement
  • Blocked glands in the eyelids
  • Eyelash mites

Some research has also shown a possible link between skin rosacea and Helicobacter pylori bacteria, which is the same bacteria that causes gastrointestinal infections.

A number of factors that aggravate skin rosacea can aggravate ocular rosacea, as well. Some of these factors include:

  • Hot or spicy foods or beverages
  • Alcohol
  • Sunlight, wind or temperature extremes
  • Certain emotions, such as stress, anger or embarrassment
  • Strenuous exercise
  • Hot baths or saunas

Risk factors

Ocular rosacea is common in people with skin rosacea, although you can also have ocular rosacea without the skin being involved. Skin rosacea affects more women than men, and ocular rosacea affects men and women equally. It's also more common in fair-skinned people of Celtic and Northern European origin.

Complications

Ocular rosacea may affect the surface of your eye (cornea), particularly when you have dry eyes from evaporation of tears. Corneal complications can lead to visual symptoms. Inflammation of your eyelids (blepharitis) can cause secondary irritation of the cornea from misdirected eyelashes or other complications. Ultimately, corneal complications can lead to vision loss.

June 25, 2020
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  2. Salmon JF. Cornea. In: Kanski's Clinical Ophthalmology: A Systematic Approach. 9th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed May 12, 2020.
  3. Ocular rosacea. The College of Optometrists. https://www.college-optometrists.org/guidance/clinical-management-guidelines/ocular-rosacea.html. Accessed May 12, 2020.
  4. Del Rosso JQ, et al. Update on the management of rosacea from the American Acne & Rosacea Society (AARS). The Journal of Clinical and Aesthetic Dermatology. 2019;12:17.
  5. Ocular rosacea. American Academy of Ophthalmology. https://www.aao.org/eye-health/diseases/ocular-rosacea-facts. Accessed May 12, 2020.
  6. Patel DR (expert opinion). Mayo Clinic. May 18, 2020.

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