How can you tell?

[elvishthistle]

I was just wondering how can you tell if you have Ocular Rosacea? My Dr's never explained why my eyes are dry they just give me solutions. I have a suspicion that I could have this. I am very fair skinned and my eyes get red/bloodshot very easily. I don't have Rosacea on my skin as far as I know. My eye doctor said my eyes just get red/vein-y because I am so fair it's more noticeable? I'm on Restasis and after I take it my eyes get red/pink, but I know that is a common side effect. So if a Dr. doesn't tell you is there any other telling sign?

[Gretchen]

ET -

Ocular rosacea manifests itself as MGD/posterior blepharitis (usually, there can be other complications but are not as common). My doctor says that usually MGD/posterior bleph is caused by ocular rosacea. You can get ocular rosacea before facial rosacea or have severe ocular rosacea and very mild facial rosacea.

Usually, ocular rosacea is inferred based on mgd/posterior bleph and dermatological symptoms. There is no "test" of ocular rosacea (although they are working on this). Frontline treatment for OR is oral doxycycline, then sometimes steroids and restasis. Really the treatment for OR is the same as treatment of lipid deficient dry eye so it really isn't all that important to know if you have OR or not, but very important to know if you have MGD as treating this may diverge from treat ment of aqueous deficient dry eye. For example, plugs are usually indicated for aqueous deficient dry eye, but usually not for ocular rosacea/MGD.

I would ask you doctor about the condition of your MGs, ask if OR is a possibility and also see a derm.

HTH,
Gretchen

[elvishthistle]

Thank you so much for the information Gretchen! I was thinking about seeing a derm just to get a definitive answer. I know my mom has a slight case of it so it's quite possible I may as well. I don't think I have MGD. But I do get clogged chalizion things a lot on my lower eyelid. That is a sign of it isn't it? Next time I see my Doctor (2 months) I will be sure to clear up what exactly it is that I have. It's good to hear that Restasis can help O.R. since i'm on it that makes me feel better that it's being helped.

Thanks again, I really appreciate it!

-ElvishThistle

[Gretchen]

ET -

If you get chalazion (esp recurrent!) you definitely have meibomian gland issues. A chalazion is a blocked and inflected meibomian gland. If you are not on it, oral doxy is front line treatment for MGD. Ask your Dr about it.

Gretchen

[elvishthistle]

ET -

If you get chalazion (esp recurrent!) you definitely have meibomian gland issues. A chalazion is a blocked and inflected meibomian gland. If you are not on it, oral doxy is front line treatment for MGD. Ask your Dr about it.

Gretchen

OK that's good to know! I had one that lasted 12 years an no optometrist ever said anything about it. I will be sure to ask about MGD during my next visit!

[mjf79]

MGD is a common syptom of ocular rosacea...I get the bumps quite often. I had horrible decline in vision with dry, bloodshot eyes last year. I went to several doctors who did the usual...systane, restasis, and plugs. The plugs only made the inflammation worse, and I recently had them out. I finally found one who immediately diagnosed me with ocular rosacea. He put me on oral doxy and topical doxy (compounded in a pharmacy)...and then I got pregnant and had to go off.
My current regimine is preservative free systane through the day. Rice bag and eyelid cleansing with cetaphil at night. i put a drop of similsan allergy drop in each eye and celluvisc for night time along with a sleep mask to protect my eyes from drafts. I have things well under control now, although it could be better! Hope this helps...I always like seeing what others are doing and get tips.
My facial rosacea was not bad, but since I have been using cetaphil on my face and preservative free drops, I've noticed a big difference all around. You might also try an omega 3 supplement to help with inflammation.

[sandra lee]

Do you get numbing,tingling in your cheeks and lids with mgd (which is what my diagnosis is) or is this more prominent in occular rosacea?Also,vision blurriness alternates from slightly blurry to extremely blurry especially when symptoms flare.My doc says it is the inflammation-not rosacea.Does anyone out there have these symptoms?Thanks so much!!!

[mjf79]

the rosacea is what causes the inflammation, which then leads to MGD. The ocular Rosacea is just the trigger for it, while others have other reasons for MGD. I had terrible vision blurriness, to where I could barely see at one point. This has improved with my daily routine to maintain the progress that I've made. The main thing for the diagnosis of ocular rosacea was that I had mild facial rosacea (of irish origin...lucky me). My eyelids looked like I had red eyeliner on, and I had prominent veins in my eyes (which is part of the infammation).

[elvishthistle]

When you say prominent veins on your eyelids, does this look like a bunch of spider veins? Because that's what I have on my upper lids near my lash line. A bunch of small little noticeable veins. I always wondered if this had anything to do with dry eye.

[mjf79]

yes, it's like a bunch of little red veins on the edges by the lashes, especially in the corners of my eyes. From my understanding, it is part of inflammation that has spread to your eye. I think that is a big part of ocular rosacea.

[elvishthistle]

Oh that's interesting, because that sounds just like what I have. I was told i'm on Restasis for inflammation too, so this is all starting to connect. I will have to specifically ask about Rosacea to get the for sure diagnosis though. Do allergies cause a flair up in Ocular Rosacea?

[mjf79]

Since I can no longer do doxy due to being pregnant, I have started a new routine which has given me relief from some of the itching and the redness in my lids. I only use CeraVe (which is cetaphil, with less alcohol) on my face and eyes. I had been using sterilid, but discovered this was causing much irritation and inflammation. So, I start with rice bag on my eyes for 5 minutes, then wash my face and soak lashes with cerave for 1 minute, massage it in and wash it off. I then dip a q-tip in hot water and swipe them across my lashes 3 times per lid. I feel this has helped with the blepaharitis. I have also started sleeping with a humidifier next to my bed at night. I got my plugs back in as the brief rest from them was HORRIBLE! I feel that this routine has helped me. I do at least 3 compresses a day and the lash cleaning 2 times. I have tried so many things and it is really a trial and error process to find what works for you. This current routine has helped with the itching that I have experienced for 6 months due to worsening bleph.

[msienkiewicz]

mjf

How do you do with plug? I have heard that people with mgd and occular rosacea should not get plugs. Do you finde that they help you or trap inflammation on your eyes?

Just wondering,
Melissa

[mjf79]

mjf

How do you do with plug? I have heard that people with mgd and occular rosacea should not get plugs. Do you finde that they help you or trap inflammation on your eyes?

Just wondering,
Melissa

I thought the same thing and got them removed and had a miserable week and a half until I had them put back in. They really were helping with my comfort level and keeping things moist. I will not be getting them out again! When I went back to get them back in the doc did another tear film test and said my eyes were "bone" dry and looked worse, and the plugs were obviously having a good effect. I have just been very careful about keeping my lids and lash margins clean and applying preservative free drops every few hours and my comfort has increased greatly.

I think if you are quad plugged that the inflammation being trapped would be the issue, as nothing would be draining out. I have just my lowers plugged with buried plugs...i don't even know they are there (I could feel the other plugs that sat above the duct surface). Mine are covered by insurance and they are easy to remove, so my feeling was to give it a shot and if they don't work, then have them out. I had them out and then back in again!

[elvishthistle]

I have bottom plugs and one fell out a few weeks ago. I can tell the difference in the eye without it! I noticed that my plugged eye is just a little puffy and the one without is normal. I will be re-plugged though, it actually feels better with the plug in.