Rosacea or “Acne Rosacea” is a common skin disturbance that causes redness in the cheeks, nose, forehead, and chin. Small blood vessels and pimples may also occur in these areas. Although the cause of Rosacea is unknown, triggers known to exacerabate the condition include sun exposure, emotional stress, heat, wind, heavy exercise, alcohol consumption and other dietary factors. Although Rosacea cannot be cured, its symptoms can be improved and controlled. The most common way that Rosacea affects the eyes is by interfering with the Meibomian glands in the eyelids. The Meibomian glands produce an oily layer that helps lubricate the eyes. This oily layer forms the outermost layer of the tear film. In Rosacea, the Meibomian glands have a tendency to clog. This can result in dry eye symptoms such as burning, redness, and reflex tearing. The eyelids can also become thickened and red. Nodules called “chalazia” (or singular chalazion) can develop which can initially be tender. Treatment for Rosacea is directed towards improving the function of the Meibomian glands. Warm compresses and lid scrubs with a mixture of warm water and baby shampoo can help keep the pores of the Meibomian glands open. The tetracycline class of antibiotics, which include doxycycline and minocycline are also commonly used. This class of antibiotic has been shown to change the fatty acid composition of the lipid secretions, decreasing the tendency for these glands to clog. This antibiotic can be difficult for some people to tolerate. If effective, the antibiotic can be taken for months. Chalazia, when they occur and do not resolve with warm compresses and oral antibiotic therapy may need to be treated with incision and curettage. With this procedure, the eyelid is anesthetized and the lesion is drained from the inside of the eyelid to avoid a scar on the skin surface. Sometimes a steroid injection is also helpful. The most serious ocular complication of Rosacea is Rosacea Keratitis. In Rosacea Keratitis, peripheral corneal infiltrates can occur which can lead to the ingrowth of blood vessels onto the normally clear cornea and cause scarring. In the worst untreated cases, the scarring can march across the cornea and damage vision. Rosacea keratitis must be treated carefully with steroid eye drops.
If you have signs of Rosacea and are experiencing ocular discomfort or blurred vision, call our office at 661-259-3937 to schedule an evaluation.