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Ocular rosacea – an eye problem or a skin problem?

Ocular rosacea – an eye problem or a skin problem?
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Ocular rosacea is inflammation of the eyes that causes burning, itching and redness. Ocular rosacea develops in people with rosacea, an inflammatory skin condition that causes redness and papules, often on the face, but sometimes getting ocular (eye) rosacea can be a sign that you will get rosacea.

Treatments for regular rosacea don’t treat ocular rosacea, leaving a treatment gap for those with the incredibly uncomfortable ocular rosacea. Ophthalmologists (these are eye doctors, not optometrists – they are vision doctors) and dermatologists are calling for both specialist disciplines to come together to try to solve ocular rosacea, since it affects both their areas of expertise.

The first port of call for a dermatologist is to treat ocular rosacea with oral antibiotics or to handball the patient to an opthamologist. What is being suggested is that treatment should occur first, with skin treatments, instead of just antibiotics or a referral. These treatments look at ocular rosacea being an eyelid disease, rather than an eyeball disease, making it skin, not eye, and therefore the realm of the dermatologist to treat effectively.

It is believed that millions of people globally suffer from rosacea, with ocular rosacea affecting up to 70 per cent, though research numbers vary widely. Many people with rosacea report eye symptoms that include irritation, grittiness, dryness and watery or bloodshot eyes. These symptoms begin after their rosacea diagnosis. Most have never been treated specifically for ocular rosacea.

A case study has been discussed whereby a 78-year-old man with ocular rosacea failed to respond to normal treatments, and was then treated successfully with dimethyl sulfoxide (DMSO) and povidone iodine (10 per cent solution) that was turned into a topical gel by a pharmacy, and rubbed into the lash line and closed eyelid twice daily. After just a week, ‘remarkable improvements were noted’, and a month later after daily applications, the improvements were far more impressive.

These two ingredients are a novel pairing, not normally used together. DMSO is a skin penetration agent rarely used in the eye industry, with povidone iodine an antimicrobial agent known as a biocide. A clinical trial is planned.

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