Therapeutical Management for Ocular Rosacea

Abstract

Purpose: The purpose of this study is to describe a case of ocular rosacea with a very complex evolution. Rosacea is a chronic dermatological disease that may affect the ocular structures up to 6-72% of all cases. This form is often misdiagnosed, which may lead to long inflammatory processes with important visual consequences for affected patients. Therefore, an early diagnosis and an adequate treatment are important. Methods: We report the case of a 43-year-old patient who had several relapses of what seemed an episode of acute bacterial conjunctivitis. Two weeks later, he developed a corneal ulcer with a torpid evolution including abundant intrastromal infiltrators and calcium deposits. He was diagnosed with ocular rosacea and treated with systemic doxycycline and topical protopic. Results: A coating with amniotic membrane was placed in order to heal the ulcer, but a deep anterior lamellar keratoplasty to restore the patient’s vision because of the corneal transparency loss was necessary. Conclusions: Ocular rosacea includes multiple ophthalmic manifestations ranging from inflammation of the eyelid margin and blepharitis to serious corneal affectations. A delayed diagnosis can result in chronic inflammatory conditions including keratinization and loss of corneal transparency, which lead to important visual sequelae for affected patients.

Ocular Rosacea Causing Corneal Melt in an African American Patient and a Hispanic Patient

“…Tissue adhesive or amniotic membrane or both should be applied over the cornea in the case of perforation or impending perforation [38, 40, 41]. Penetrating keratoplasty may be necessary in many severe cases [12, 41]. …”

Cryopreserved Amniotic Membrane, Autologous Serum Eye Drops, and Tea-Tree Oil Lid Scrubs in combination for the treatment of Keratoconjunctivitis in a Staphylococcus Hypersensitive Teenager

“…Rosacea is known to be associated with meibomianitis, chalazia and hordeola. 14,15 The patient was not manifesting obvious meibomianitis. She also lacks any skin abnormalities, such as acne or telangiectasia of the face.…”

Ocular Rosacea

“…Ghanem et al reported that the most common ocular signs in patients with rosacea from the ophthalmologic clinic were meibomian gland dysfunction (MGD) in 85.2%, lid margin telangiectasias in 53.4%, blepharitis in 44.3%, and interpalpebral hyperemia in 40.9%. Accordingly, patients from the dermatology clinic were reported to exhibit MGD in 27.3%, chalazion/hordeolum, lid margin telangiectasia in 18.2%, anterior blepharitis in 13.6%, and pinguecula in 13.6% [9] Vision loss is a rare but devastating complication [43]. OR has been graded as mild, moderate, and severe ( Table 2) Table 1.…”

“…Reduced fluorescein tear breakup time, punctate staining on the cornea, and bulbar conjunctiva (Figure 1). Superficial punctate keratopathy (due to tear film instability), dry eye disease, blepharitis, styes, MGD, eyelid inflammation-collaretes, telangiectasis, conjunctival hyperemia, conjunctival scarring, punctate epithelial keratitis, corneal infiltrate/vascularization, corneal thinning, corneal astigmatism, corneal ulceration, phlyctenules, phlyctenular keratitis, limbal pannus, episcleritis, scleritis, corneal melting, and perforation, iritis, periorbital edema, recurrent chalazia, pannus, neovascularization, trichiasis (Figures 1-5) [43][44][45][46].…”