Ocular Rosacea - Subtype 4

Ocuar Rosacea
image - eprocrates.com

Ocular problems occur in at least 50 percent of patients with rosacea. source

There may be a clinical diagnositic test now available for ocular rosacea. source • another source

One report says, "researchers discovered that the presence of high levels of oligosaccharides in human tears may be a diagnostic indication of ocular rosacea, and that high levels of 13 particular types of the compound were associated with rosacea and may serve as more specific markers for the disorder. Since a general increase of oligosaccharides may not necessarily be specific to rosacea, they emphasized that the types of oligosaccharides found in greatest abundance in rosacea patients should be evaluated in further research for their specificity as markers for ocular rosacea." source

Here is a quote from an article, "Occular Rosacea," by J Bradley Randleman, MD, and C Diane Song, MD, which in part says,

"...rosacea may be thought of as a disease spectrum with 2 primary etiologic components, vascular and inflammatory. The earliest manifestations of the disease are cutaneous vascular dilatory changes with subsequent increased blood flow in the form of telangiectasias and erythema...

The later stages of rosacea are marked by inflammatory changes in the form of papules and pustules in the midface, rhinophyma (bullous nose), blepharitis and meibomitis, and corneal vascularization. A type 4, cell-mediated hypersensitivity reaction has been hypothesized as a possible mechanism. Demodex mites also have been implicated as a possible inflammatory stimulus. Additionally, Helicobacter pylori has been postulated to be a causative factor in a subset of patients. Whatever the underlying mechanism, there is a fundamental abnormality in the sebaceous glands of the face and eyelids, which leads to the inflammatory changes exhibited....In the US: More than 10% of the general population exhibits dermatologic characteristics of rosacea..."

source > http://www.emedicine.com/OPH/topic115.htm

Diagnosis

"The high abundance of oligosaccharides in the tear fluid of patients with rosacea may lead to an objective diagnostic marker for the disease."
Glycomics Analyses of Tear Fluid for the Diagnostic Detection of Ocular Rosacea
yun Joo An, Milady Ninonuevo, Jennifer Aguilan, Hao Liu, Carlito B. Lebrilla, Lenio S. Alvarenga, and Mark J. Mannis
J. Proteome Res., October 6, 2005

There are some photos of advanced ocular rosacea, Subtype 4, at the bottom of the above article. It is bizzare to me that anyone would wait that long to go to a dermatologist for help when as the article so clearly states at the bottom, "Failure to recognize, diagnose, and treat rosacea can compromise the integrity of the ocular surface." It also says that "Additionally, ophthalmologists probably underdiagnose rosacea due to a lack of familiarity with the dermatologic manifestations of the disease."

When it comes to occular rosacea here are my suggestions:

Read Dr. Latkany's book, The Dry Eye Remedy

(1) Tea Tree Oil • OcuSoft Products

(2) Read Dr. Nase's book

(3) Read Dr. Nase's comment on occular rosacea. Read The New Age of Ocular Treatments

(4) Try the Rosacea Diet for thirty days

(5) Carbomer gel that contains superoxide dismutase

(6) Cutting Edge Eye Drops

(7) Vitamin A, Vitamin C, & Gluthathione > source

(8) Eye make up suggestions > source

(9) rosaceagroup.org occular page

(10) Four new eye drops

(11) Cyclosporine drops

(12) Laser Eye Correction Specialists

(13) Pilocarpine gel

(14) Isoptocarbachol 3% eyedrops

(15) Alice Haddow's Advice

(16) American Academy of Family Physicians suggested treatment:

"Oral tetracycline and doxycycline effectively control the ocular symptoms of rosacea; these are the only agents that have been rigorously studied in the treatment of ocular rosacea2,15 [Evidence level B, nonrandomized studies]. A short course of topical corticosteroid solution may be useful for symptomatic relief of ocular rosacea2; however, ocular steroid therapy should be initiated and managed by an ophthalmologist because experience with this treatment is limited. Liquid tears are useful for dry eyes and relief of ocular itching.2 Low-dose treatment with oral isotretinoin (10 mg, three times weekly for two to three months) has also been successful in recalcitrant ocular cases2 [Evidence level C, expert opinion]." source

"...We surveyed retrospectively the different ocular parasitosis and mycosis diagnosed in our laboratory (Sfax hospital) over a 4 year-period (1996-1999)...Parasitic agents were dominated by Demodex folliculorum (32 cases)..." source

17. Anecdotal Report of a cure for blefaritis and rosacea.

Ronald Boender reports an anecdotal report of a cure for rosacea by "washing my eyelids with Johnson's baby shampoo twice a day with very hot washcloths" and has "been cured for 6 years now and threw away my tetracycline." Ronald says he "read about Demodex folliculorum on the web and realized this was probably my cause of rosacea." source

Demodicosis of ophthalmic concern.

(18) Ocular Rosacea: Dr. Eric Jones, MD

(19) Ocular Rosacea: Dr. Mark J. Mannis, MD

(20) treating ocular rosacea (from the AAO)

(21) Reply to Mona

(22) Scott's 'cure' • More Scott

(23) Restasis • Another link

(24) Lisa's long post

(25) Drop-Free Dry Eye Treatment

(26) NRS Report "Easing Eye Irritation"

More to come, so come back soon for new updates to this page...