Ocular Rosacea - can my experience help reduce the confusion it seems to create.

[hannsho]

Ocular rosacea is a systemic disease related to the faulty functioning of the immune system. It has many symptoms, which frequently also occur with other eye conditions and is therefore difficult to diagnose. The resulting underdiagnosis by doctors and Ophthalmologists (a failure to diagnose ocular rosacea) has been confirmed by a number of scientific studies.

In my case it is only fairly recently that I found an ophthalmologist (a specialist in ocular surface disease), who actually diagnosed me with ocular rosacea. Underlining the difficulty in diagnosing ocular rosacea correctly, Browning and Proeia (1986) suggested in a research paper that to confirm a correct diagnosis it would normally be necessary to detect some symptoms of facial rosacea, which is difficult since the symptoms of facial and ocular rosacea do not always manifest at the same time. However, they also suggested that if systemic treatment with tetracycline produced good results, that this also constituted confirmation of the presence of ocular rosacea. The problem with an incorrect diagnosis is that the patient may not receive the best possible treatment, which I think has been the case with some of the treatment I received in the past.

The Mayo Clinic in NY provides a an excellent short description of ocular rosacea, which includes a list of the usual symptoms. If you have a high score on the symptoms listed and in addition have facial rosacea, then this is a good indication that you have ocular rosacea. I have facial rosacea and score 9 out of the 10 symptoms listed. This is the link to the paper from the Mayo Clinic:

https://www.mayoclinic.org/diseases-...s/syc-20375798

[hannsho]

I'd like to add a further explanation as to the importance of being diagnosed correctly with ocular rosacea. My understanding is that ocular rosacea does not distinguish itself by a set of clearly defined diagnostic symptoms and signs, but rather by the cause of those symptoms. As I mentioned above, ocular rosacea is a systemic disease related to the faulty functioning of the immune system. So, for example, if you have an inflammatory process going on in your eyes or eyelids, then the cause would not be an infection or an environmental influence, but a systemic cause. As such an important therapeutic part of the treatment would be systemic, say with oral tetracyclines, in addition to topic treatment rather than relying exclusively on topic remedies in the form of some type of eyedrops or ointment. Topical treatment may not be the best choice for recalcitrant recurring blepharitis. A deficient diagnosis may, therefore, lead to a patient not receiving the optimal treatment for his / her eye condition.