New member with ocular rosacea

[Brooke]

Hi all,
I am a new member with dry eye due to ocular rosacea. I've had my symptoms for about a year, and have been using warm compresses with massage daily plus restasis. I noticed an initial improvement when I started this regimen, but it seems that it is losing its effectiveness and that the bad days are getting more frequent. I also have tried many types of fish/flax oil and take those daily, along with NAC. My eyes feel more tired and burn as the day goes on, and my lids start to get red and twitch. The restasis really helped the twitching at first but now it is back.

I'm really glad to have found this site and have done a lot of reading. Any help you have would be great!

[fed up kate]

hi brooke

dont know if you tried cold compresses rather hot,i find that helps me when mine are buring also makes them water slightly which feels great
sorry i cant be more of a help with the rosacea but there are many people on here with it who im sure will help you.

kate

[Brooke]

Thanks for the reply. I sometimes use a cold compress when my eyes feel particularly tired or inflamed, and it does help relieve the symptoms temporarily. I use heat/massage because my lid margins often have little white bumps and the heat sometimes helps lessen them. But I often wonder if using heat is counterproductive, because it seems to make my lids somewhat red. Does anyone know if it is bad to forego heat altogether if the margins appear somewhat clogged? I want to help unclog them but do not want to cause further inflammation at the same time. Thanks!

[ringo]

Heat and cold compresses and massage surely helps...but unfortunately these are only palliative measures which will not eradicate the problem; they can only help you cope better.

Doxycycline has been shown to help with reducing inflammation, bacterial colonization and restoring meiboian glands function, which in turn can produce more liquid secretions. Prior or during treatment you might ask a professional to express the oil from the glands if you feel they are clogged.

Also, like I suggested to others, Azythromycin drops have a very potent effect on both infection and inflammation. They can be combined witha weak steroid. This regimen will both alleviate symptoms and tackle the root cause of the problem, while you continue with the compresses and massages.

I have always had bad experience with heat myself. My eyes do not toelrate heat. That makes them more red and inflamed.But everyone reacts differently.It might work for you.

[Gretchen]

Hi Brooke -

Welcome. I too have ocular rosacea. I have had marked improvement in my condition from low dose doxycycline (you may start at 100mg and then taper to a lower dose for maintenance). Some others on here have also had success with doxy. Some others have had no response at all. But this is true of almost all dry eye therapeutics. You will need to do a lot of iterative experimentation to find out what works for you. Good news is that there are a lot of things for you to try and chances are that something will help. Below are some things that have worked for Or'eans. You may want to look in the archives for some of them as there have been extensive discussions on all of these treatments:

1. heat and qtip extraction/massage of the MGs - tried and true, pretty simple. Some folks have responded really well to these, others find that it actually exacerbates their ocular rosacea (which makes sense since heat causes vessels to expand which could cause a flare) try this as well as cool compresses. As for me, heat or cold never did a darn thing for me.

2. Doxy - like I said, you can start with 100mg and go down to a lower dose for maintenance. This is the first line defense for most folks with Ocular rosacea. My symptoms got a lot better with this, but I still did not have resolution.

3. Azasite - These are the azithromycin drops that Ringo was talking about. Some folks have had amazing results, others nothing, and some had a bad reaction (unfortunately, I had the latter) Def worth a shot

4. Z-Pak - Like doxy, it is an antibiotic, but for OR is used for it's anti-inflammatory properties. It packs a serious punch as it has more side effects than the lower dose doxy, but something to think about if you have no luck with the other stuff.

5. Restasis - Some OR folks have really good results, others not so much. It is expensive and takes a while but something to look into.

6. Steroids, ie, Alrex, Lotemax, Pred Forte - These can be used for when you get in trouble as "pulse therapy". Works for some to calm inflammation, but they say not to use them long term. Some of the lighter steroids such as Alrex and Lotemax actually have pretty good long-term studies. But Drs are terrified of these steroid drops. If they work for you, you are going to have to fight to keep your RX filled.

7. Lid scrubs - Ocusoft works. Don't do Baby Shampoo. Your doctor will tell you to, but don't listen. It will kill your eyes.

8. Allergy drops - Many OR folks have allergies. Pataday or Patanol can help.

9. IPL - this has helped some folks with OR, me included. I will be posting later this month on IPL after I receive my 4th treatment.

10. Last and most importantly, you need a good eye doctor who will work with you on all of the above. You need him to write your scripts.

I wish you the best of luck.
Amy

[Brooke]

Thanks Amy for all the helpful suggestions! Much more thorough than I have ever received from any of the doctors I've seen! You mentioned the Z-Pac. Do you mean the 10 day antibiotic course that doctors normally prescribe for respiratory/ear infections, etc? I haven't heard of that potential treatment for MGD/ocular rosacea.

I will probably try doxy soon. One doctor recommended 100 mg of doryx (100mg once per day), while another recommended 200mg of doxy (100mg 2x per day). Do you know the difference between the 2 and what the appropriate dosage should be?