Ocular Rosacea

[sazy123]

I saw Dr. Latkany the other day and I asked him some questions that have been puzzling a number of us on here lately regarding rosacea. It's very difficult to find much info online regarding ocular rosacea - it always ends up being an explanation of facial rosacea.
According to Dr. L:
1. EVERYONE who has facial rosacea has ocular rosacea. Just some people have a higher level of inflamation
2. Ocular rosacea is an inflamation of the eyelids as well as the eyeballs.
3. Ocular rosacea doesn't directly cause dry eyes. It does, however, directly cause MGD. MGD causes dry eyes.
4. There is no cure for rosacea. Our intent should be to get it under control.
5. Doing your best to prevent flare-ups of facial rosacea should help keep ocular flare-ups under control, too.
6. Hot compresses are not good for rosacea. Warm is OK but the best option is to let the water in the shower hit your face and do the lid massages (expressing the oil glands) right after your shower.
7. Cold compresses are fine as often as you need them. Not ice cold. Just cold. Ice cold can aggravate rosacea, too.

More than this I can't tell you. I'm suffering from both facial and ocular rosacea problems currently. Just wanted to pass along the answers I got.

Mine is ocular rosacea of the inner eyelids (chronic conjunctivitis), It is the inflamed eyelids that are the problem im sure of that, because when im ill- this inflammation goes away and my glands work fine.

Unfortunately all these treatments do absolutely nothing for the inflammation when its there (i.e when i have no other illness, most recent being tonsilitis).

Its sooo frustrating, because i know these things help for other ocular rosacea sufferers because Dr lackney treats them, but not me! its like banging my head against a brick wall all the time!! I just wish i could find something that could make this dry eye manegable, not even progesterone cream can do that! Probably assuming thats because it treats the outer side of the eyelids and M glands and NOT the inner eyelid inflammation which is where the problem is. Maybe Azasite will.

4 years on and still not able to live a decent life.

[NYer]

Sazy,
Two points about what you wrote there...
1. Are you assuming that conjuntivitis and rosacea are the same thing because they are both inflammations? They are not the same thing. Do you have a diagnosis of rosacea?

2. The fact that your eyes feel better when you're sick does not mean that it is your eyelids that are causing the problem...a LOT of us, with various causes of dry eye, feel better when we are feeling terrible. In other words, when we get colds or flu, etc., all of a sudden our eyes feel great.
No straight answers on that from any of the eye docs on that. In fact, when I asked Dr. L about that, he said it's not the case...but obviously for an awful lot of people on here, that IS the case, so that is another dry eye mystery.

[sazy123]

Well i definately have inflammation of the inner eyelids and you can see they are swollen abit- both signs of ocular rosacea. I also have MGD and very mild facial rosacea- im fair skinned 'keltish'. From my reading conjunctivitis means different things, acute is bacterial, chronic is usually caused by allergies or ocular rosacea. Since mine is definately not allergies, ocular rosacea makes sense. My eyes are white, but ocular rosacea can involve eyelids or the eyes, doesnt have to be both. Doctors have mentioned conjunctivitis but they dont understand the ocular rosacea connection so usually blame it on allergies.

This redness and inflammation of inner eyelids goes away when ever im ill. Wish i taken a picture now, coz the last 4 months ive had tonsilitis, so eyes have been fine. It definately does effect us, contrary to what Dr l says, i know it first hand it does, its not just a slight improvement, its 90% improvement.

I think its due to the autoimmune process of inflammation in ocular rosacea, when theres something else going on in the body that requires the immune system i.e the flu, the auto immune inflammation reaction to my eyelids stops because the immune system is focusing its resources to flu etc. its well known that an auto immune reaction occurs in facial rosacea- thats what causes all the permenant redness/inflammation in the face, which is after the first stage- vascular flushing. Only explanation that makes sense to me.

Heres a pic of eyelids (now) when they are bad, this redness goes right down when they are not bad:

[skygoddess]

It sounds like you suffer many of the same problems I do.
Azasite helps me tremendously. As well as Cold Compresses, and staying away from the baby shampoo.
I was mildly allergic, but when your eyelids are irritated , even a mild allergy is major.

[NYer]

Sazy,
That's a very interesting point about the autoimmune quality of the condition. Have you spoken to Dr. L at all? His own dry eye condition was set off by a case of conjunctivitis, too. So he may be able to give you some good info. Also, there may be something to the allergy stuff even though standard logic would say not. And the reason I say this is based on Skygoddess's recent experience. The standard allergy doctors test you for for all the standard stuff (I am allergic to dust and mold, for example...so are lots of people...and that's not causing my dry eyes.) But Sky had patch tests for an astounding variety of contact allergies and found out she was allergic to things you'd never consider...and from what she has said, since staying away from that stuff, she's seen a big improvement. (and I hope that's still the case.) And her problem, I believe, was also very eyeLID oriented. So you may want to look into that.

[jenny2008]

It's odd but I have ocular rosacea and my dr.. Dr. Foulks still advised me to do warm compresses followed by a technique of massage he showed me that differs somewhat from others techniques I have seen. I noticed the first time I did the massage after the heat that I heard a squishing sound in my eyes when pushing gently along my eyelids. After a few days I just kept feeling better and better.

It's been 2 and 1/2 weeks and I feel sooo much better. My eyes are never inflammed anymore and the tissue is a light pink color not red. I do the heat and massage 2x daily for now and I guess it means my oil glands are finally working-although I have to do it manually.

With that said-we all differ -as with my ocular rosacea the heat does wonders..

[NYer]

Jenny,
Please, please, please elaborate on the different massage technique that has worked for you! I find that the standard one we all use is very irritating to my eyes. After I do it, my lids are red and my eyes are burning for quite a while. That's with or without using hot compresses first. I'd love to know what you're doing that's working so well.
Thanks!

[jenny2008]

--------------------------------------------------------------------------------

I do the compress for a couple of minutes and than the massage.. I usually take the compress off when it cools off which is usually a few minutes. The massage I do is similiar to what i found in this link.. http://www.agingeye.net/otheragingeye/blepharitis.php

I put a washcloth on top of my finger as I sweep it across my eyelid w/ firm pressure while keeping the eyelid taut . First you need to make sure that you pull your eyelid shut and down over to the side... And then you sweep your finger (with the washcloth on it) over your closed taut eye starting at the nose and sweeping it toward your ear-do this 5-6 times.. My doctor used the analogy of unclogging a clogged tube of toothpaste--you basically are using a smoothing motion from the corner of your eye by your nose to the opposite side and repeat...

I hope the above link helps you . I can hear the oil actually come out while doing the sweep motion. I hope this makes sense.. let me know!

[jenny2008]

eyelid massage technique

I scanned the technique Dr. Foulks gave me but I can't attach on here-it says it is too big of a document. If you can give me an email (or send one to me in a private message) i will email it to you.