Rosacea can involve the eyes as ocular rosacea, inflaming the eyelids, tear film, and surface of the eye. This often leads to symptoms of dry, gritty, burning eyes alongside facial skin changes.
Ocular Surface Effects
Ocular rosacea commonly causes meibomian gland dysfunction and blepharitis, which destabilise the tear film and increase evaporation.
- Patients may have redness of the lid margins, watery or bloodshot eyes, and recurrent styes or chalazia.
- In more severe cases, inflammation can extend to the cornea, causing keratitis, thinning, or ulcers that threaten vision.
- Fluctuating blur and light sensitivity are frequent complaints.
- Triggers such as heat, alcohol, spicy foods, and wind that worsen skin rosacea can also flare eye symptoms.
Management
Treatment focuses on lid hygiene, tear-film support, and anti-inflammatory therapy, often coordinated between ophthalmology and dermatology.
- Warm compresses, lid cleaning, and preservative-free lubricants form the foundation of care.
- Oral tetracyclines or macrolides, topical antibiotics, and sometimes steroid or immunomodulatory drops are added for more active disease.
- Controlling facial rosacea and avoiding known triggers helps stabilise the ocular surface over time.
- Regular monitoring is important when there is corneal involvement to prevent scarring and vision loss.
