A manifestation of rosacea that affects the eyelids and eyes is called ocular rosacea. The most common symptoms include redness, burning of the eyes and irritation. Those who are suffering from rosacea may feel that they are having something like an eyelash in their eyes. The redness can spread among the nose and cheeks too. Caffeine, alcoholic beverages and spicy food can increase the symptoms of this condition.
The most common treatments for ocular rosacea consist of warm compresses, oral antibiotics and doxycycline. The treatments are directed towards symptomatic control and disease prevention rather than complete cure. The main cause of ocular rosacea is an inherent defect in the immune system of the patient.
Treating ocular rosacea must be done with a step by step approach. The eyelid hygiene should be taken are of in the first place. This should be followed by topical and oral medications. Surgical intervention is the last resort if required.
The lid hygiene is the most important part of the treatment of ocular rosacea. Hot compresses to the margins of the eyelid will assist in liquefying the meibomian gland secretion and facilitate their expression. Applying a mild non-irritating cleaning solution such as a diluted baby shampoo can help to remove clogging debris. There are eyelid scrubs in the market that can be effective in this regard. Light pressure applied on the eyelids also can help in gland expression.
Patients with ocular rosacea are normally placed on oral antibiotics. Tetracyclines are the most common antibiotic used in this regard. They are effective due to the secondary effect they exert on meibomian glands.
Tetracyclines decrease bacterial lipase which help to change the fatty acid concentration of the meibomian secretions, thereby improving their solubility. These medications are effective in protecting the cornea from impending inflammatory responses.
Metronidazole is the other medication that is being used for ocular rosacea. It exhibits antimicrobial, anti-inflammatory and immunosuppressive properties. Hence it has been found to be effective against ocular rosacea. Side effects such as gastrointestinal irritation is common while using this medication. Abstaining from alcohol is essential while on this medication.
Topical steroids are the other useful medications for ocular rosacea. This is helpful for short-term exacerbation of lid disease and management of inflammatory keratitis. Steroids should be used only with approval of your physician, and should be discontinued as soon as possible in order to prevent corneal melting.
Retinoids such as oral isotretinoin and topical tretinoin (vitamin A derivatives) are found to be effective in reducing the inflammatory lesions in rosacea. This is achieved through suppression of sebum production. Tretinoin is helpful to restore sun damage skin by increasing the production of type 1 collagen.
Prednisolone acetate which is a corticosteroid is effective in suppressing inflammatory changes in the cornea. It also suppresses the migration polymorphonuclear leukocytes and reverses increased capillary permeability. Immunosuppressants are the other category of drug that is helpful in controlling ocular rosacea. Restasis is an immunosuppressant used to relieve dry eyes.
Ophthalmic lubricants are the other effective medication category used in controlling ocular rosacea. This lubricant will act as humectants in the eye. The ideal lubricant should be preservative free, and contain potassium bi-carbonate and other electrolytes for better effect. Lubricant drops can prevent morbidity and further complications. Lubricating ointments is helpful in preventing complications that would arise from dry eyes.
Artificial tears are also used to improve the lubrication of the eyes. Artificial tears without preservatives are used for this purpose. A lubricating ointment with antibiotic preparations can be used in the night in order to keep the eyes hydrated always.
Natural eye creams also have been found effective in treating the symptoms of ocular rosacea. Hauschka Revitalizing eye cream with jojoba oil and other natural ingredients, is one such effective cream. Trying a bit of the cream, on non sensitive areas is important before applying it for ocular rosacea. The main ingredients of this cream include water, avocado, glycerine, pineapple and almond. These creams have no side effects because they are prepared of 100% natural ingredients.
Home remedies and lifestyle changes are important in controlling ocular rosacea. Keeping the eyelids clean by gently washing them with warm water is very important. This should be done on a daily basis for optimal results. Do not wear contact lenses during flare-ups, especially if you have dry eyes due to ocular rosacea.
Artificial tears also can be used to relieve dryness of the eyes. Your doctor may advice you regarding this. Continuing the treatment for sometime is important as ocular rosacea can return at anytime. Avoid extreme temperature, sun exposure, spicy foods, alcohol and stress, which are stimulators of ocular rosacea.
Ocular rosacea must be controlled by following healthy lifestyle changes, hygienic practices and preventive techniques, which can help you to live a healthy life free of ocular rosacea.