Ocular Rosacea

Overview

What is ocular rosacea?

Ocular rosacea is an inflammatory disease that affects your eyes and the skin around them. It’s a form of the broader skin disease rosacea that affects your whole face. It’s also sometimes called meibomian gland dysfunction (MGD).

Ocular rosacea is a chronic (long-term) disease that has no cure. You can manage it with treatments and avoiding your triggers.

Who does ocular rosacea affect?

Ocular rosacea can affect anyone. A few groups of people who are more likely to develop ocular rosacea include:

  • Adults between 30 and 50.
  • Women and people assigned female at birth.
  • People with light or fair skin.
  • People from Western European ethnic backgrounds (especially from England and Scotland).

How common is ocular rosacea?

Experts estimate that around 5% of people worldwide have some form of rosacea. However, many people with mild symptoms never have their rosacea diagnosed. People tend to assume symptoms of ocular rosacea are issues like seasonal allergies or problems with their contact lenses.

If you experience new symptoms — especially if they come back more than once — talk to your healthcare provider.

How does ocular rosacea affect my body?

Ocular rosacea causes symptoms in and around your eyes. It might make your eyes and the skin around them irritated, painful, itchy and uncomfortable.

Symptoms and Causes

What are ocular rosacea symptoms?

Symptoms of ocular rosacea include:

  • Inflamed or swollen eyelids (sometimes referred to as blepharitis).
  • Swelling around your eyes.
  • Discoloration or redness around your eyes.
  • Pink eye (conjunctivitis).
  • Bloodshot eyes.
  • Itching.
  • Burning.
  • Dry eyes.
  • Watery eyes (or excess tears).
  • Crusty discharge in your eyelashes.
  • Recurring styes or chalazia.
  • Sensitivity to light.

Ocular rosacea symptoms on skin of color

Rosacea is sometimes only associated with “redness” on white or fair skin. But people with darker skin and skin of color can get ocular rosacea too.

Many of the symptoms are the same, but rosacea’s trademark discoloration might be harder to notice on dark skin. It might not also show up at all. Symptoms of ocular rosacea on skin of color include:

  • A warm or hot feeling around your eyes.
  • Discoloration around your eyes that’s a darker brown than your usual skin tone.

What causes ocular rosacea?

Experts aren’t certain what causes ocular rosacea. Some possible explanations include:

  • A genetic disorder that you’ve inherited from one or both parents.
  • Bacteria (specifically the same Helicobacter pylori bacteria that cause some gastrointestinal diseases).
  • Environmental irritants.
  • An issue with your circulation that makes your blood vessels swollen.

Although no one knows for sure what causes rosacea, some circumstances and conditions are known to trigger it, including:

  • Exposure to UV light (like sunlight or tanning beds).
  • Stress.
  • Exposure to intense weather (like heat, wind or the cold).
  • Drinking alcohol.
  • Eating spicy foods.

Diagnosis and Tests

How is ocular rosacea diagnosed?

Your healthcare provider will diagnose ocular rosacea with a physical exam. Make sure you tell them about all the symptoms you’ve felt, even if they get better before your appointment.

Your symptoms, medical history and whether you’ve noticed any triggers are the only way to diagnose ocular rosacea, so every detail you share can help your provider diagnose your issues correctly.

What tests will be done to diagnose ocular rosacea?

There are no tests to diagnose ocular rosacea. Your provider will make a diagnosis based on your symptoms, medical history and whether or not you’ve responded to any common triggers of ocular rosacea.

Management and Treatment

How is ocular rosacea treated?

The most important aspect of treating your ocular rosacea is knowing — and avoiding — your triggers. This is especially true because there is no cure for rosacea. Knowing what triggers your symptoms is the best way to avoid experiencing them.

Other treatments include:

  • Warm compresses on your eyes both during and right after bathing.
  • Artificial tears or eye drops that contain lipids.
  • Doxycycline (an antibiotic pill).
  • Washing your eyes with pH-balanced cleansers (instead of just soap).
  • Wearing sunscreen (always use SPF 30 or higher).

What can’t I eat or drink with ocular rosacea?

You should avoid foods and drinks that trigger your ocular rosacea symptoms. For most people, this includes spicy foods and alcohol. Your triggers will be unique to you. Once you know what can aggravate your ocular rosacea, you can avoid it as often as possible.

Ocular rosacea treatment complications

The biggest complication of ocular rosacea treatment is that your symptoms get so bad they affect your eyes and vision permanently. There’s also a risk that touching your eyes can lead to infections.

How do I manage my ocular rosacea symptoms?

Managing your ocular rosacea symptoms is mostly about avoiding their triggers. It might help you to keep a list or a journal of what does or doesn’t trigger your symptoms. This can be especially helpful right after your diagnosis. Use a warm compress on your eyes a few times per week when you’re experiencing symptoms.

Make sure you’re following the treatment plan your provider gives you. Even when you’re not having a flare up or your symptoms are under control, it’s important to use your medicines and other preventive treatments as often as you should.

How soon after treatment will I feel better?

You should feel better a few weeks after starting new treatments to manage your symptoms. If you need steroid eye drops or other medications, it might take anywhere from a few days to a few weeks for them to start working.

The treatments will not cure your ocular rosacea, but they should relieve your symptoms and make you more comfortable during a flare.

Prevention

How can I reduce my risk of ocular rosacea?

After you’ve been diagnosed with ocular rosacea, the best way to reduce your risk of future flares is to know and avoid your triggers. Some of the best ways to prevent flares include:

  • Limit your sun exposure.
  • Find ways to cope with stress in your life.
  • Get a healthy amount of sleep.

How can I prevent this?

There’s nothing you can do to prevent ocular rosacea. Once you’ve been diagnosed, you should focus on managing your symptoms and avoiding your triggers to make sure you have flares as infrequently as possible.

Outlook / Prognosis

What can I expect if I have ocular rosacea?

You should expect to have ocular rosacea for a long time, possibly for the rest of your life. Some people have fewer flares as they learn to manage their triggers, but there’s always a possibility your ocular rosacea will come back.

Do I need to miss work or school?

You shouldn’t need to miss work or school. If you’re especially sensitive to light, or your symptoms make it hard to read or look at a computer screen, you might need to take some time away from your job or studies while you’re experiencing a flare. Talk to your provider about which activities you should avoid during a flare up.

What is the outlook for ocular rosacea?

Overall, the outlook for ocular rosacea is positive. Even though it can be uncomfortable and annoying, it is not a life-threatening disease, and it won’t cause you to lose your vision. Once you learn the best ways to manage your symptoms and avoid your triggers, you should be able to minimize how much ocular rosacea impacts your life.

Living With

How do I take care of myself?

Follow the treatment plan from your provider as best you can. A big part of living with ocular rosacea is knowing what can trigger your symptoms and doing your best to avoid those triggers.

When should I see my healthcare provider?

Talk to your healthcare provider if you notice your symptoms getting worse, or if your flare ups happen more frequently.

Make sure to mention any new or different symptoms too. Your provider can adjust your treatment options to fit your current symptoms as they change over the course of your life.

When should I go to ER?

Go to the emergency room if your symptoms include:

  • Intense pain.
  • Double or blurry vision.
  • Dizziness.
  • Loss of vision.

What questions should I ask my doctor?

  • What treatments do I need?
  • Will I need any medicines?
  • Do I need to see a specialist?
  • What activities, foods or drinks should I avoid?

A note from Cleveland Clinic

Being diagnosed with any chronic condition means you unexpectedly have a lifelong disease to manage. That includes ocular rosacea. It can seem overwhelming at first, but as you learn what helps you control your symptoms and which triggers to avoid, you should be able to get into a good rhythm of feeling like yourself again. Your healthcare provider can help you come up with treatment plans and strategies to avoid your triggers.

Last reviewed by a Cleveland Clinic medical professional on 01/04/2022.

References

  • American Academy of Dermatology Association. People with skin of color can get rosacea. (https://www.aad.org/public/diseases/rosacea/what-is/skin-color) Accessed 12/3/2021.
  • American Academy of Dermatology Association. Rosacea treatment: eye problems. (https://www.aad.org/public/diseases/rosacea/treatment/eye-problems) Accessed 12/3/2021.
  • American Academy of Ophthalmology. Ocular rosacea. (https://www.aao.org/eye-health/diseases/ocular-rosacea-facts) Accessed 12/3/2021.
  • MedlinePlus. Rosacea. (https://medlineplus.gov/rosacea.html) Accessed 12/3/2021.
  • National Rosacea Society. Coping with rosacea. (https://www.rosacea.org/patients/materials/coping-with-rosacea/coping-with-common-triggers) Accessed 12/3/2021.
  • StatPearls. Rosacea. (https://www.statpearls.com/ArticleLibrary/viewarticle/28642) Accessed 12/3/2021.

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