Ocular rosacea  

Rosacea

• mid facial flushing, redness, prominent vasculature, sweling, papules and/or pustules

Ocular Rosacea

• Usually exisitng rosacea but can be first sign
• Ocular rosacea involves eyelids and the front of the eye
  • Blepharitis
  • Conjunctival hyperaemia
  • Rosacea associated keratitis/marginal keratitis
• Middle aged

Clinical

• Itching, burning, increased tears, photophobia, foreign body sensation, dry eye, inflamed papules, corneal ulcers, red eye
• Anterior blepharitis – inflammation lid margin and lid line
  • Swelling lids
  • Redness/dilated vessels
  • Scaly debris at eyelashes
  • Loss or misdirected eyelashes
• Posterior blepharitis
  • obstruction of ducts and meiobian glands – conjunctival hyperaemia, cloudy secretions, reactions in tarsal plate, chalazions, external hordoleum
• Cornea – keraitits – more rare Iritis, scleritis, episcleritis – rare

Management

• Hygiene – dilut baby shampoo warm compresses
• Artificial tear/ lubricants avoid contacts
• Topcial antimicrobials – chloramphenicol
• Topical antiinflammatory
• Systemic antibiotics – if more severe – doxycycline