Ocular Rosacea—a Review

O cular rosacea, a disease often associated with acne rosacea, can present with a variety of clinical features, which are often nonspecific. However, in about one-third of cases, it may occur as an isolated entity without skin involvement. Appropriate diagnosis and management is essential as potentially sight-threatening corneal involvement can occur in a significant number of patients if the condition remains unrecognized and untreated. Diagnosis remains mainly clinical and includes recognition of the commonly occurring signs of chronic blepharoconjunctivitis, lid margin telangiectasis,meibomian gland dysfunction, dry eyes, and corneal involvement in the form of vascularization, infiltration, and even perforation. Management depends on the severity of the disease, with milder forms being amenable to treatment with local measures like lid hygiene and topical lubricants, while more severe forms require treatment with systemic drugs including tetracyclines, azithromycin, erythromycin, or metronidazole and more aggressive local therapy with topical steroids and/or topical cyclosporine. Surgical treatment may be required to manage the sequelae of chronic ocular surface inflammation.