This article is more than 5 years old. Information may no longer be current.

Rosacea: Consider in patients with red eye

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

PHILADELPHIA – Eye care practitioners should be aware of the prevalence of rosacea when examining patients with red eye, according to two optometrists lecturing here at the PCON Symposium.

“This is a great primary care disease. It’s misdiagnosed frequently by eye care doctors,” said Christopher J. Quinn, OD, FAAO, a Primary Care Optometry News Editorial Board member and president of Omni Eye Services in Iselin, N.J. “Almost two-thirds of patients who have rosacea have ocular rosacea.”

Twenty percent of rosacea sufferers have ocular symptoms as the presenting sign, he added.

Some of the signs of ocular rosacea include meibomian gland dysfunction, evaporative dry eye associated with poor meibomian gland function and blepharitis.

“When you see blepharitis, it’s important and incumbent on you to go back and look at the patient and see if they have any of the dermatologic manifestations of rosacea,” Dr. Quinn said.

Some pre-disposing factors to rosacea flare-ups include age, gender, diet, medications, environment, systemic health, refractive surgery and contact lens wear.

Refractive surgery can exacerbate a rosacea patient’s dry eye symptoms, Dr. Quinn said.

He said treatment for rosacea patients can include tetracycline for its anti-inflammatory effect. Dr. Quinn’s co-lecturer, William Townsend, OD, warned, however, that the tissue-damaging drugs have photosensitizing side effects, chelate with dairy products and may cause gastrointestinal distress.

“I’ve seen some awful sun burns that I caused by prescribing tetracycline for inflammatory lid disease,” Dr. Townsend said. “I told the patient in a very casual way ‘you need to protect yourself from the sun,’ and then they come back and they’re as red as a lobster because they didn’t really heed it. Hammer that home.”

Drs. Quinn and Townsend suggested using Periostat (20 mgs doxycycline hyclate) to treat the ocular rosacea, as well as a new antibiotic called Oracea (30 mg of immediate release and 10 mg of slow release doxycycline).

They also suggested prescribing MetroCream 0.75% (Galderma) for the dermatologic manifestations of rosacea.