Ocular Rosacea

What is ocular rosacea?

Ocular rosacea is a condition that causes inflammation in your eyes and the skin around them. It’s a specific type of rosacea — a skin disease that causes inflammation and discoloration on your whole face. Healthcare providers sometimes call ocular rosacea “meibomian gland dysfunction.”

Ocular rosacea might make your eyes and the skin around them feel irritated, painful, itchy and uncomfortable when you’re having a symptom flare-up.

There’s no cure for ocular rosacea, but a healthcare provider or eye care specialist will help you manage your symptoms and avoid the triggers that make them worse.

What are ocular rosacea symptoms?

Ocular rosacea symptoms usually come and go in episodes called flares or flare-ups. Which symptoms you have may change over time or between flare-ups.

The most common ocular rosacea symptoms are changes you can feel and see on the skin around your eyes, including:

• Inflamed or swollen eyelids (blepharitis).
• Discoloration or redness around your eyes.
• Swelling.
• Itching.
• Burning or a feeling of heat.
• Styes or chalazia.

Ocular rosacea can cause symptoms in your eyes, too. You might experience:

• Pink eye (conjunctivitis).
• Bloodshot eyes (red eye).
• Dry eyes.
• Watery eyes (epiphora).
• Crusty discharge in your eyelashes.
• Light sensitivity (photophobia).

Many people picture rosacea causing “redness” on only white or fair skin. But people with darker skin can have ocular rosacea, too. Many of the symptoms are the same, but rosacea’s trademark discoloration might be harder to notice. You might not be able to see it at all. If you can see discoloration around your eyes, the affected skin might be darker than your usual skin tone.

What causes ocular rosacea?

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

• A genetic disorder that you’ve inherited from one or both biological parents.
• Bacteria (specifically the same Helicobacter pylori bacteria that cause some gastrointestinal diseases).
• Environmental irritants (like pollution, exposure to chemicals or toxins).
• An issue with how blood circulates that makes blood vessels around your eyes swell.

What causes ocular rosacea flare-ups?

Even though researchers aren’t certain what causes ocular rosacea, they’ve found some triggers that lead to flare-ups. A trigger is something that causes symptoms to flare up or get worse.

Common ocular rosacea triggers include:

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

What happens if ocular rosacea goes untreated?

It’s rare, but untreated ocular rosacea can damage your eyes and permanently affect your vision.

You also have an increased risk of eye infections if symptoms like itching or burning make you reflexively touch your eyes. Try to avoid rubbing your eyes, and make sure you wash your hands before touching your eyes and face.

How is ocular rosacea diagnosed?

A healthcare provider or eye care specialist will diagnose ocular rosacea with a physical exam and eye exam. They’ll examine your skin and eyes. They might check your vision, too. Tell your provider about all the symptoms you’ve felt, even if they got better before your appointment.

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

What are ocular rosacea treatments?

The most important part of managing ocular rosacea is knowing — and avoiding — your triggers. It might not always be possible, but avoiding activities, foods or situations that might trigger ocular rosacea flare-ups is the best way to minimize how often you experience symptoms.

There’s no cure, but your provider or eye care specialist will suggest treatments that help you manage symptoms, including:

• Putting warm compresses on your eyes (especially during and right after bathing).
• Artificial tears or eye drops.
• Doxycycline (an antibiotic pill).
• Washing your eyes with pH-balanced cleansers that are labeled as safe to use around your eyes and eyelids.
• 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.

How soon after treatment will I feel better?

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

The treatments won’t cure ocular rosacea, but they should relieve your symptoms and make you more comfortable during a flare-up.

How can I prevent ocular rosacea flares?

Some of the best ways to prevent ocular rosacea flares include:

• Limiting your sun exposure.
• Finding ways to manage stress, like working with a mental health professional.
• Get a healthy amount of sleep.

It might help to keep a list or a journal of what triggers your symptoms. This can be especially useful right after your diagnosis.

Make sure you’re following the treatment plan you work on with your provider. Even when you’re not having a flare-up, it’s important to use your medicines and other preventive treatments as often as your provider prescribes.

How do you get rid of ocular rosacea?

You’ll probably need to manage ocular rosacea symptoms for a long time (maybe for the rest of your life). There’s no cure for it, so there isn’t any treatment that can make it go away permanently.

Most people with ocular rosacea experience fewer (and less severe) flare-ups once they learn to identify and avoid their triggers and find treatments that help manage their symptoms.

When should I see my healthcare provider?

Visit your healthcare provider or eye care specialist if it feels like your symptoms are getting worse or if you’re experiencing flare-ups more often.

Make sure to mention any new or different symptoms as well. 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 the emergency room?

Go to the ER if your symptoms include:

• Intense eye pain.
• Dizziness.
• Double vision.
• Blurry vision.
• Loss of vision.

Which questions should I ask my healthcare provider?

• Which treatments will I need?
• Which type of sunscreen do you recommend?
• Which activities, foods or drinks should I avoid?
• How often will I need follow-up appointments?

Is ocular rosacea an autoimmune disease?

Some researchers think ocular rosacea might be an autoimmune disease, but we don’t have enough proof to say for sure that it is.

Autoimmune diseases happen when your body’s immune system attacks your body instead of protecting it.

Some studies have found that some people with ocular rosacea experience flare-ups after triggers make their immune system become overly active, but this isn’t true for all people.