Rosacea and Dry Eyes Part 4 - why eye doctors get involved.

There is general agreement that Ocular Rosacea (OR) is common, under-recognized and under-treated. Yet the consequences of OR can be severe and sight threatening.

This article published a review of records from 131 patients who had Ocular Rosacea (OR) and were seen and treated by corneal specialists in referral practices (so not the average eye care clinic). Clearly some of these patients had been referred by general eye doctors because they had exhausted treatments they could offer locally - so this group of patients might be regarded as the “worst of the worst,” as opposed to the more average patients with more average/milder levels of eye diseases.

A “foreign body sensation” is also described as “a scratchy feeling” (like something got in the eye) and is perhaps one of the most common presenting complaints eye doctors see, along with burning (and, in pollen season, itching). Telangiectasias are the dilated, otherwise small blood vessels I described in the opening segment of ths series on Rosacea. Irregularities of the eyelid margin are common among those with chronic “blepharitis” (inflammation of the lids) and in those with a history of styes (which are also common in Rosacea patients). Meibomian Gland Dysfunction (or MGD) is an active cause of dry eye disease in up to 85% of sufferers - so while any one of these findings are beyond common to the majority of patients eye doctors see, the combination of these problems will most often indicate Ocular Rosacea. That 13 of these patients (or 10%) had compromised corneas which also compromised their vision is scary and even scarier is that six of these patients (roughly half) required corneal transplants (Penetrating Keratoplasty) in an attempt to restore their vision. Cicatrizing conjunctivitis is when there is scarring of the membrane over the white of the eye - which can lead to an inability to move the eye without causing pain and/or double vision and can lead to an inability to fully close the eye.

We will get into treatment strategies for Rosacea in general, and Ocular Rosacea in particular in future posts. Of note, is that some of the patients in this series were left legally blind and one lost their eye as an uncommon but frightful result of this disease. Since this disease affects both skin and eyes, it may require the combined skills and efforts of skin (dermatologists) and eye doctors (optometrists and ophthalmologists). It also requires eye doctors to “step back” and look at the whole face of their patients (and for skin doctors to also look at their patients eyes).

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