Ocular Rosacea

Abstract

Acne rosacea (AR) is a chronic cutaneous inflammatory disease of the midface. Ocular involvement occurs in 30-70% of patients. Although the incidence of this disease is seen highest between the ages of 30 and 50 years, it can also develop during childhood. The diagnosis depends on clinical findings such as meibomian gland dysfunction (MGD), conjunctival hyperemia, and corneal vascularization, and untreated cases can progress and lead to vision loss. Pathogenetic factors can be the altered the immune system, colonization of microorganisms, inflammation, abnormalities of sebaceous, and meibomian glands, environmental factors, and vascular dysregulation. Differential diagnosis from other ophthalmologic and dermatologic diseases is important. Management requires an interdisciplinary approach with a step-wise treatment algorithm. Patients should be informed about the chronic course of the disease and avoid the exacerbating factors. Caring about the lid hygiene and use of non-preserved artificial eye tears, topical ointments including antibiotics, anti-inflammatory agents are used when necessary. However, the mainstay of the therapy is the use of oral antibiotics for a long period. Surgical interventions may be needed in cases with a vision-threatening condition. During the long-term treatment period and disease course, the complications of medications should also be considered cautiously and patient should be followed up routinely.