Many people that acquire the rosacea don’t realize that it can also affect their eyes. The condition may include dry eyes, tearing, swollen eyelids, burning and recurrent styes. This condition is called ocular rosacea and if left untreated can also cause vision loss. Early identification and treatment is essential if your eyesight is to be saved from corneal damage. Here are ten ocular rosacea treatment options you may want to consider.
1. Tear Film Supplementation
Artificial tears is a basic ocular rosacea treatment. That’s because it helps to stabilize the oily layer of the tears by treating the fluctuation in the tear film that accompanies the condition. It will help minimize dry eye syndrome although it is not a cure. It’s important to use only “doctor recommended” eye drops or others that have been recommended by the American Optometric Association. The eye drops should be used several times per day and should be replaced monthly to prevent cross-contamination.
2. Hygiene of the Eyelids
When it comes to milder cases, an important treatment is eyelid hygiene. Placing warm compresses on the eyelids several times per day will help. However, it’s also important to wash the eyelids using a Q-Tip and diluted baby shampoo which is tear-free. Gently roll the eyelid back then take the Q-Tip that has been dipped in the solution and gently rub the underside of the eyelid area. Finally, rinse the solution away with a warm water rinse.
The procedure should be repeated as often as necessary to relieve symptoms. Always remove makeup thoroughly and change all eye makeup containers monthly in order to avoid contamination. Finally, avoid wearing contact lenses during flare-ups.
3. Eyelid Hyperthermia
In order to reduce the thickness of gland secretions in the eyelid while reducing bacterial growth, heat is a good ocular rosacea treatment that should be considered. Heat between 105-110 degrees applied directly to the underside of the eyelid can work, but is risky because you’re working so close to the eyeball itself. If using this method it’s important to roll the eyelid back as far away from the eyeball as possible before applying the heat.
4. Topical Medications
We begin this treatment option with a caution. Topical antibiotics and antibiotic steroids carry a higher risk of complications although they also can help a great deal. AzaSite (azithromycin) is a mainstay of the treatment regimen which reduces symptoms associated with the condition but has not been approved by the FDA for this purpose. The advantage is that it’s an anti-inflammatory as well as antibiotic yet contains no steroids.
The severity of the condition can vary widely and knowing which treatment is best for the stage you’re at could be highly beneficial. In more severe cases, ocular rosacea treatment often includes fatty acid supplements high in omega-3. They should only be taken under a doctor’s supervision and be avoided by those taking blood thinners, coumadin or aspirin. In most cases it is highly effective at stabilizing the eibomian glands in the eyelids that results in reduced inflammation.
6. Lifestyle Changes
Certain things can trigger or exacerbate the symptoms of ocular rosacea. Things that dilate the blood vessels should be avoided. Those would include spicy foods, chocolate, cheese, caffeine and hot as well as alcoholic beverages among other things. Additionally, some medications can make it worse as can prolonged exposure to sunlight, extreme weather conditions and emotional and physical stressors. If you’re on blood pressure medication, be sure and take it as directed since it counters constricting of the blood vessels.
7. Oral Medications
Derivatives of tetracycline have been shown to be a highly effective ocular rosacea treatment option that decreases symptoms as has doxycycline, erythromycin and minocycline. The more severe the case, the longer the antibiotic treatment will last. It is designed to reduce bacteria production of lipases which are chemicals that change the consistency of oils in the eyelid glands. It also produces an anti-inflammatory effect, but the treatment may take many months before the results become apparent.
8. Pulsed Light
Most people are familiar with the pulsed light used by dermatologists to remove hair as well as reduce skin pigmentation. Expansion of its use now includes use as an alternative treatment for ocular rosacea. It works by constricting blood vessels and decreasing inflammation of the eyelids. It’s important to remember that treatment can only be performed by a skin care professional.
9. Clinical Trials
There are many ocular rosacea treatments. However, the goal is to find what works long-term while diminishing the loss of eyesight in the majority of candidates with severe cases. TearSciences’s LipiFlow is a device that emits thermal pulses that massages and heats the meibomain gland contents in order to liquefy and then express them. It resembles a contact lens that slides over the globe of the eye and under the lid. That way, during the procedure, the eyeball is protected while the treatment can be performed on the underside of the eyelid. It is currently in clinical trials. If you would like to be considered for inclusion in the study, contact your ophthalmologist.
Since ocular rosacea is an incurable disease that affects millions of people, research continues on options with some new, highly effective strategies emerging. However, currently there is a lack of understanding of the molecular and immunologic mechanisms responsible for its onset. That’s what makes it so difficult to treat.
Occasionally, surgery is the only effective course of action, but it also has its limitations. For example, ocular plugs can be inserted in the eye in order to relieve the symptoms of dry eye syndrome. However, corneal transplants are rarely effective due to inflammation which prevents corneal neovascularization. New research involving surgery, however, are continuing and also showing great promise.
Ocular rosacea accompanies skin rosacea which is caused by defects in the body’s immune system and vasoregulatory processes. Therefore, to control the symptoms, early treatment is essential. Typically, a combination of local and systemic therapy along with cleansing and tearing agents work best. Working in conjunction with your ophthalmologist, dermatologist and physician will ensure you’re receiving the best ocular rosacea treatment possible and save your eyesight.