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An underdiagnosed skin condition call rosacea is increasingly recognized as a cause of several common eye problems. These include meibomian gland dysfunction , dry eyes, blepharitis , eyelid mite-infestations called demodex and recurrent chalazion . These disorders are just part of a spectrum of diseases we call - ocular rosacea.
This photo demonstrates a moderate case of ocular rosacea. Most cases of ocular rosacea however are so mild they are undiagnosed. Even though the diagnosis is frequently missed, it can cause significant discomfort to a patient.
Source : MedScape
In rosacea, the eyelash follicles are frequently infected with mites called Demodex Follicularum. Usually, the surrounding facial skin is infected with mites as well. These mites cause blepharitis, eye irritation, dryness and in more advanced causes vision loss.
Well over 16 million Americans have rosacea and the vast majority are unaware they have it.
More advanced cases of rosacea are obvious. Patients can have thick ruddy skin sometimes with acne. Rosacea can affect any skin color.
The majority of rosacea cases are less obvious cases and are frequently overlooked, even by dermatologists. These patients show up in our office with irritated and sometimes red eye. Many of patients with minimal rosacea have a history of easy facial blushing. Blushing may be associated with a sense of heat that comes and goes. Many people with early rosacea also flush when drinking red wine. Red wine flushing is a strong indicator someone may have underlying rosacea regardless of race.
In the last few years, there has been an increased understanding of rosacea. The cause is in part from a dysfunction of the skin nerve endings causing skin inflammation. Rosacea also is affected by malfunctioning our immune system. Rosacea can be associated with other inflammatory disease like MS or colitis. Most people who are affected are between the ages of 45-60. Caucasians with sun sensitive skin are more at risk. Rosacea is linked to anxiety and depression. There is a higher family incidence suggesting it can be in part genetic in origin.
Patients with rosacea have a significant increase in the number of skin mites infesting their skin as well as eye lashes. This is called demodex follicularum. Demodex mites can adversely affect one’s skin condition if not controlled.
Other factors listed that patients report affect their skin (in decreasing numbers) include:
Treatment entails avoiding the triggers of rosacea. Skin sun block is recommended when outdoors.
Intense Pulse Light Therapy (IPL) is a proven effective treatment to reduce the skin redness inflammation and associated dry eyes. In addition to improving the skin appearance and eye dryness, IPL also is very effective in killing skin mites called demodex that frequently infect rosacea patients’ skin and eyelids. All major institutions including Johns Hopkins, Mayo Clinic, and Harvard offer this treatment. At InVision we have over five years’ experience with in-office IPL treatments. Not everyone is candidate for IPL.
For eyelids that are significantly affected by blepharitis we offer an excellent method of cleansing the lids called Blephex. Blephex an in-office treatment which is quick, effective, and painless. It helps patients suffering from stubborn blepharitis not amenable to home lid scrubs. Blephex is also effective in killing demodex mites as well.
InVision became the first eyecare practice on the Jersey Shore to offer IPL treatment for rosacea dry eyes. These are performed under the direction of the founder of our Dry Eye Relief Center - Dr Kinnari Patel. We use the latest equipment and algorithms for treatment. We also have in-office laboratory facilities for the detection of demodex mites that may be aggravating your skin and eyelids.