Rosacea and Dry Eyes - a common pairing that needs recognition and treatment!

In simplest terms, Rosacea is sensitive skin and irritable oil glands. It commonly runs in families and is most obvious in those with pale skin but can affect any colored skin type (with darker skin harder to see the redness in, but can be no less affected than their pale-skinned friends). There are 4-subtypes and each can be graded from mild to severe (see my slides below). Because eyes are often affected - and eye doctors use microscopes to examine the eyelids and look closely at their patient’s faces, we frequently are the first to diagnose Rosacea (before their PCPs and often, even their Dermatologists do).

How Red is my face? ETR is all about the redness. Telangiectasias are the fine, red, “spider lines” caused by dilated superficial blood vessels. Less superficial vessels can dilate more broadly and give the general red hue to those affected.

“I’m too old for zits!” Papulopustular Rosacea fits the “Rosacea as Adult-Acne” theme. Papules are red bumps, and pustules are “white-headed zits.” Erythema is the undercurrent of facial redness like the ETR type listed above.

Why is my nose swelling up? Phymatous Rosacea is sometimes referred to as the W. C. Fields’ “Whiskey Nose,” but does not need alcohol to trigger it.. Even emotional flushing with the right genetic makeup can fuel it. Swollen vessels carry lots of blood and the thinner walls of the dilated vessels can leak clear blood-fluids rich in growth factors - acting like fertilizer to affected skin and making it grow thicker and bigger.

A common cause of chronic “red eye” (though there are many others) - most patients will have both eyes affected - but not always equally - and styes are common. This type can occur in conjunction with any of the above rosacea subtypes but can also occur by itself or before the other types become obvious. Once it affects the clear window of the eye called the cornea, severe damage can occur (typically, KERATITIS - a form of inflammation that can lead to scarring and loss of vision if central, or less commonly, ULCERS - a thinning and weakening of the cornea commonly related to infections that can lead to perforation and loss of the eye).

Since Rosacea can have devastating consequences for significantly affected eyes and eyelids, recognition is key as it should then lead to proper treatments. Even modestly affected eyes can have real - if not devastating consequences, I find most dry eye specialists to be uniquely suited to helping their patients with Rosacea - and future pasts will help to further explain the nature of Rosacea - the (good and bad) things that can affect it and some of the better treatments we can use to make it better.

To schedule an appointment with Dr. Jaccoma, call Excellent Vision at either of these two dry eye offices:

(1) 155 Griffin Rd, Portsmouth, NH 03801 (603) 574-2020

(2) 3 Woodland Rd, STE 112 Stoneham, MA 02180 (near Boston) (781) 321-6463