Ocular rosacea, an often overlooked yet common component of rosacea affecting up to 72% of patients, could lead to severe vision loss if not properly diagnosed and treated, according to a new review.
This chronic inflammatory condition affected the eyes and periocular skin and was frequently misdiagnosed as part of the broader rosacea skin disease. The review, published in the Journal of Clinical and Aesthetic Dermatology, provided detailed insights into the clinical features, differential diagnoses, and treatment options for ocular rosacea, aiming to aid ophthalmologists in better identifying and managing this condition.
Rosacea is commonly known for its facial skin manifestations, including persistent erythema, papules, pustules, and rhinophyma. However, ocular rosacea, which affects both sexes equally, can lead to complications such as Meibomian gland dysfunction, blepharitis, conjunctivitis, and vision loss if left untreated. Symptoms include dryness, burning, redness, and blurred vision, impacting patients' quality of life by causing physical discomfort, anxiety, and social withdrawal.
The review described the multifactorial pathogenesis of rosacea, involving neurovascular and immune dysregulation, microorganisms, and UV radiation. Clinical features of ocular rosacea were often nonspecific, making it challenging to distinguish from other ocular diseases without cutaneous symptoms. Early recognition was crucial, as timely intervention could prevent severe complications.
Treatment options varied, ranging from conservative eye care methods like artificial tears and lid hygiene to topical and systemic therapies. Topical azithromycin, cyclosporine, and ivermectin had shown efficacy in managing symptoms. Systemic therapies like doxycycline and oxytetracycline were also effective, particularly in subantimicrobial doses to reduce gastrointestinal side effects. Newer procedural treatments, such as Intense Pulsed Light and Lipiflow, showed promising results in improving Meibomian gland dysfunction, a common feature of ocular rosacea.
Despite the available treatments, the condition remained chronic with cycles of remission and relapse. The review highlighted the need for greater awareness and more effective therapies to reduce the burden of ocular rosacea on patients' lives.
Full disclosures could be found in the study.