Ocular Rosacea

[Margaret]

Ok, so trying to go at this in a different direction. Post Lasik, nearly 10 months, upper lids sore, MGD - which is getting worse, just diagnosed with Ocular Rosacea, sebhoric dermatitis.

Anyone out there with Ocular Rosacea?

Anything working?

Can any veteran think of something they had heard of in the past that has helped?

I'm on Doxy 200 mg a day, moisture chambers, refresh tears, genteal gel

Thanks!
Margaret

[dave25]

I have ocular rosacea as well so I will tell you what has worked for me. I take tetracycline 250mg 2x a day. I use Restasis 4x a day. I use Acuvail 2x a day. I use Pataday 1x a day. I use Bion Tears about 3-4 vials a day. I also do cold compresses 2x a day. I am not 100%, but I am a lot better. I also take fish and flaxseed oil.

I try to stay away from warm compresses now and gels seem to further irritate my eyes so I try to stay away from those as well. It is really important to take good care of your skin and try to notice if you have any rosacea triggers. Mine are heat and extensive sunlight (the antibiotics probably don't help that either) , but I know there is a long list of rosacea triggers and everyone is different. I hope this helps and good luck on getting better.

[Margaret]

Dave,

Thank for your reply! What do you think works the best (what can you not live without) or do you think it's a combination of it all together?

My doc wants me to do the warm compresses for now, but I agree it's a trigger. He wants me to push through anyway for a couple of weeks to just try to break up the oils...

Gels aren't great for me either. Alcohol is a trigger for me, but haven't figured out any others yet.

Do you know a lot about Ocular rosacea? What do we need to "worry" about (loss of vision, healthy corneas, MG's, etc).

Thanks for your help,
Margaret

[dave25]

I don't know a whole lot about ocular rosacea. Unfortunately, until doctors figure out more about what rosacea actually is it's going to be difficult to understand what ocular rosacea actually is.

According to Brady Barrows book rosacea is a chronic and progressive disorder of the face, characterized by some or all of the following symptoms: Extremely sensitive skin, blushing, flushing, redness, stinging, burning, red gritty eyes, etc. He then goes on to say ocular problems occur in at least 50% of patients with rosacea.

For me the two most important things I use are Restasis and Tetracycline, but I think the combination of everything I do is important because when I stop doing something I notice a difference. Until there is a breakthrough in the understanding of what actually causes rosacea I think we just have to keep on trying to find the regimen that provides the most relief.

The Rosacea 101 book by Brady Barrow is very informative and I think even Dr. Latkany suggests reading it if you are looking for information on rosacea.

[Margaret]

Thanks Dave,

Do you know of any other people I could get in touch with to talk about ocular rosacea (maybe people on this site, or veterans that have been on the site). I am still struggling to cope...

Margaret

[dave25]

Your welcome Margaret. Rebecca would probably know a lot more people than I do; she may be the best person to ask.

[Margaret]

not to wear out my welcome, but have you tried any cream based products for eyes (metrogel comes to mind). How about Azasite? have you considered IPL?

Thanks again,
Margaret

[dave25]

Ask as many questions as you want, I don't mind. I have not tried any creams for my eyes because I think most doctors will caution against that. I do use sodium sulfacetamide for a face cream though. I think applying creams to the eyelids may do more harm than good.

I have tried Azasite and that helped a little, but not a lot for me. I know Azasite has really helped some people though so it may be worth a try. During my search for the right regimen I went through a 3 year period where I was always asking my doctor to try something new because I was in so much pain. So in my opinion if you are in a lot of pain it might be worth it to try some new things and see if they work for you.

[dave25]

I have never tried IPL because my doctor has always told me that my lid margins look pretty decent. However, it is something I may want to try in the future just to see if it helps. It is always good to have options.

[Margaret]

thanks again, as always!

My problem is of course dryness and burning of my right eye, but I also have bumps and redness under my upper lids. Do you experience that? I do have MGD, so IPL may help me and is on my list too.

Have a good day!
Margaret

[dave25]

Yes, I have small bumps and redness under my upper lids as well. Did you experience any skin problems before you had Lasik? How were your eyes before the procedure?

[Margaret]

No, no skin problems at all. I flush when I'm embarrassed or talking in front of a large group and always noticed that, but everyone always talks about how GOOD my skin looks (if only I had skin like yours) sort of thing. Strange, eh? I did have contact intolerance in hindsight but perfectly feeling/working eyes without contacts in them! Have you found any relief for the bumps/redness? I think that's my main issue, other than a patch of MGD on my right eye, or at least these are the problems I would like to attempt to figure out. That was why I was asking if an antifungal cream treatment would work on the upper lids from the top, rather than from underneath. I read somewhere researchers found that relieved some swollen eye lid issues.

Thanks again!
Margaret

[dave25]

I know people can get ocular rosacea without having any facial symptoms, but it is probably not as common. I never had any eye problems until I was 21 years old; I did have some mild acne though. I had an allergic reaction from my contacts and that seemed to set in motion my eye disorder. After my allergic reaction I could never fully get rid of the inflammation in my eyelids. At first I was diagnosed with ulcerative blepharitis and then a few years later I was diagnosed with ocular rosacea. For you it seems the Lasik surgery set your eye condition in motion. Sometimes however I noticed that people on this forum with just Lasik complications and no ocular rosacea used different regimens from me that were very effective for them so I think this is an important distinction to make.

I have not been able to get rid of the redness under my eyelids. I think the medication I take helps keep the inflammation at bay, but does not fully get rid of it. Do you have any allergies? Sometimes people with ocular roacea are more prone to allergies.

[Margaret]

I think you are right. I had contact intolerance, that probably in part set everything in motion, and then Lasik was the final hit. I do have seasonal allergies, but had a complete panel done and didn't show much else. I agree with you. I think there are post Lasik people that I have talked to that have very different symptoms (RCE's for instance). I have a feeling that is prominently a lacrimal gland issue. I'm not putting eye drops in my eyes every 15 minute, my eyelids are swollen and painful and either that is exacerbating my dry eye, or I have dry eye and it's exacerbating my eyelids I am hoping that at least by taking Doxy I will find out which one it is. How long did it take you to feel any difference with Doxy? I'm on day 6, I've heard it takes anywhere from 2 weeks to 3 months. Reminds me of Restasis.

Thanks again, like always,
Margaret

[dave25]

I take tetracycline now, I used to take Doxy, but they are pretty much the same thing. I had raw and red skin on the corners of my eyes due to seborrheic dermatitis and the doxy cleared that up which I was very thankful for because it improved my appearance.

I have never noticed a huge improvement in how my eyes felt when taking antibiotics. Maybe a little improvement in the stability of my tear film. I think taking antibiotics keeps the rosacea and other skin ailments at bay and this overall helps the eyes and eyelids improve a little as well. It took about 2-3 weeks I think to take full effect. I hope this helps.