Veins on eyelids - rosacea?

[hopeful_hiker]

Hi everyone!

I am in the midst of trying to figure out my dry eye diagnosis. I am curious about rosacea signs and symptoms. I found that when I google ocular rosacea, the photos are usually on the more obvious side of the disease spectrum.

I have visible veins on my eyelids (especially upper), and they make their way into the eyelid margin (visible under the microscope).

Are eyelid spider veins (telangiectasia) an ocular rosacea sign?

If you have mild (or mild moderate) ocular rosacea:

What does it feel like? What does it look like? How did your doctor diagnose it?

In my case, 2 out of 5 doctors said I have ocular rosacea. Others were more hesitant. I have some blocked glands, normal oils, normal Shirmer’s (but I am sure a lot of it was reflex tears), negative blood work and lip biopsy for Sjogren’s.

[diydry]

My last doctor said I have it too. I'm honestly not sure what it means, whether it refers to somewhat prominent arteries on my eye, a general redness on the white of the eye which I assume is a result of inflammation and scoring positive for MMP-9 inflammatory marker, or whether it's telangiectasia (is that what you're referring to by veins on the eyelids?), Online medical sources seem to use ocular rosacea almost interchangeably with blepharitis. I will have to ask my doctor what a diagnosis of ocular rosacea means and how it differs from bleph/MGD when I follow up later this month.

FYI, my glands are not very blocked right now (especially after Lipiflow) but the oil is thick and abnormal and I've been unsuccessful in achieving normal oils. If your glands are blocked I wonder if Lipiflow or IPL will help you?

[hopeful_hiker]

diydry, thank you for the response! I am thinking of IPL but I keep getting mixed messages from doctors in regards to my signs. Some say I have moderate MDG, others say my meibomian glands are just a bit blocked.

[hannsho]

Hi Hopeful_Hiker
Ocular Rosacea is difficult to diagnose, because it has many symptoms that could also occur with other non-specific inflammatory processes. I believe one of the symptoms that is often associated with ocular rosacea is eyelid-margin telangiectasia. According to a study 'Review: Ocular Rosacea' (Browning and Proeia1986) the presence of ocular rosacea is usually confirmed definitively if the patient also suffers from facial rosacea. Hope that is useful.

[MGD1701]

Found this from Dr/Professor Alice Epitropoulos,
whom I adore so much so I have been following her at Twitter to learn NEW/correct info

11 People Describe What It's Really Like to Have Rosacea

I have posted a few photos below from the article, for easy reference
interesting article! Hope it helps. No idea how to make the photos smaller???
https://www.self.com/story/what-its-...o-have-rosacea

[hopeful_hiker]

Found this from Dr/Professor Alice Epitropoulos,
whom I adore so much so I have been following her at Twitter to learn NEW/correct info

Thank you for your response. I definitely have some patches of skin that look like 2. Not as drastic but still visible. I will see check out more info about the prof, too.

hannsho,

Thanks! I will be seeing a dermatologist next week. I do have minor telangiecstacia I believe.

[MGD1701]

Hi hopeful_hiker

According to these top female doctors/professors, pure HOCL, like Avenova are helpful for patients with rosacea

''Diagnosing and treating Ocular Surface Disease in Female Patients - An ASCRS roundtable discussion with
Kendall Donaldson, MD, Elizabeth Yeu, MD, Peerya Gupta, MD, and Neda Shamie, MD.''
https://www.youtube.com/watch?v=m-JzH9UNrQU&t=4s
There is a lengthy version, if you care to learn more.

[hopeful_hiker]

Update. So I do have ocular rosacea... but I forgot to ask how the doctor figured that out. Will ask next time and report what to look for. I have normal oils but blocked gland openings.

[MGD1701]

Thanks for sharing.

ocular rosacea
Did dr recommend you anything then?
Do you have oily face on the t-zone?

Thank you!

[hopeful_hiker]

Thanks for sharing.

ocular rosacea
Did dr recommend you anything then?
Do you have oily face on the t-zone?

IPL (did my first round this week).
No, I barely have any rosacea, if any, on my face so my skin is normal.

[PG]

Yes the telangiectasia is a symptom of ocular rosacea.
I also have ocular rosacea and no other type of rosacea (none of the girls in the pics above have ocular rosacea).
I don't have telangiectasia on my lids, I have pink lower lid margins when I have the rosacea.
So there are triggers and cause the rosacea. There are websites on this. My triggers are vinegar and alcohol.
It causes inflammation of your glands, and contributes to dry eye per my doctor. It is a PITA.

[MGD1701]

''The presence of telangiectasias of the lid margin with conjunctival inflammation suggests a chronic inflammatory component such as ocular rosacea, a co-morbid contributor to dry eye disease.''

this is from dry eye expert, Dr L. Periman, recent article. 4 Sept. 2018 ''Sharpen your medical mind. Be a dry eye sleuth.''

Anyone knows how to detect conjunctival inflammation, with MMP-9 or staining? just curious.
so rosacea = telangiectasias + conjunctival inflammation, right?

I like her last sentence,
''Patients don’t need yet another artificial tear; they need an intellectually curious problem-solver, a systems optimizer, a dry eye sleuth.'' --- these make her successful - she cares for patients & results.

http://www.ophthalmologytimes.com/bl...leuth/page/0/3