Ocular Rosacea Follow-up

  • Author: J Bradley Randleman, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Aug 23, 2011
 

Further Inpatient Care

  • Inpatient care is rarely necessary, except in some cases of corneal perforations or severe secondary corneal infections.
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Further Outpatient Care

  • Rosacea is a chronic condition, and long-term management is necessary to control this disease.
  • Dermatology and ophthalmology visits may be necessary, and they could initially be frequent to gain control over the symptoms or to protect an endangered cornea.
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Inpatient & Outpatient Medications

  • Lid hygiene
  • Artificial tears
  • Oral antibiotics - Doxycycline, tetracycline, clarithromycin, or metronidazole
  • Erythromycin ointment
  • Topical metronidazole
  • Topical steroids
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Deterrence/Prevention

  • Patients should avoid trigger foods and situations.
  • For some patients, avoidance of sunlight can minimize flare-ups.
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Complications

  • Complications include corneal vascularization, ulceration, perforations, secondary bacterial infections, and, ultimately, decreased vision.
  • Eyes undergoing penetrating keratoplasty are more likely to experience graft rejection than eyes without rosacea because of the increased inflammatory response and the relatively increased corneal vasculature.
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Prognosis

  • Rosacea can be controlled symptomatically but is generally a chronic condition, which requires long-term, follow-up care.
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Patient Education

  • Informing patients of the chronic, relapsing nature of rosacea is important so that patient expectation matches available therapy and patient follow-up care is maximized.
  • Ophthalmologists may underdiagnose rosacea because of a lack of familiarity with the dermatologic manifestations of the disease.
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Contributor Information and Disclosures
Author

J Bradley Randleman, MD  Associate Professor, Department of Ophthalmology, Section of Cornea, External Disease and Refractive Surgery, Emory University School of Medicine; Director of Cornea, External Disease and Refractive Surgery Fellowship, Emory University; Physician Member, Section of Ophthalmology, The Emory Clinic

J Bradley Randleman, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Cornea Society, and International Society of Refractive Surgery

Disclosure: Nothing to disclose.

Coauthor(s)

Evan S Loft  MD, Clinical Assistant Professor, Department of Ophthalmology, Emory University

Evan S Loft is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, and Phi Beta Kappa

Disclosure: Nothing to disclose.

C Diane Song, MD  Chief of Ophthalmology, Asheville Veterans Affairs Medical Center

C Diane Song, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Bhairavi Kharod-Dholakia, MD  Director, Refractive Service, Assistant Professor, Department of Ophthalmology, University of Arkansas for Medical SciencesAssistant Professor, Department of Ophthalmology, Emory University

Disclosure: Nothing to disclose.

Sheetal M Shah, MD  Associate Professor, Department of Ophthalmology Emory Eye Center and Emory Vision

Sheetal M Shah, MD is a member of the following medical societies: American Academy of Ophthalmology and Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Fernando H Murillo-Lopez, MD  Senior Surgeon, Unidad Privada de Oftalmologia CEMES

Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Christopher J Rapuano, MD  Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Director of the Cornea Service, Co-Director of Refractive Surgery Department, Wills Eye Institute

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology

Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching; EyeGate Pharma Consulting; Inspire Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching; Bausch & Lomb Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the assistance of Ryan I Huffman, MD, with the literature review and referencing for this article.

References

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Typical dermatologic findings of rosacea, including midfacial papules, pustules, and rhinophyma.
Typical findings of rosacea, including papules, pustules, and rhinophyma.
Ocular rosacea. Eyelid telangiectasias with inspissated meibomian glands.
Ocular rosacea. Peripheral corneal pannus.
Ocular rosacea. Extensive corneal pannus with thinning.
Ocular rosacea. Extensive corneal neovascularization and opacification.
 
 
 
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