Rosacea Review - Newsletter of the National Rosacea SocietyRosacea Review - Newsletter of the National Rosacea Society

Researchers Make Advances in Understanding of Ocular Rosacea

A new technique for improving the eye symptoms of ocular rosacea, a possible biochemical clue to its diagnosis and a potential link between Demodex and the development of corneal ulcers are among the advances from National Rosacea Society-funded researchers to appear in recent medical journals.

Dr. Edward Wladis, a previously funded NRS researcher, recently reported in the journal Ophthalmic Plastic and Reconstructive Surgery that probing to clear blockage of the meibomian glands — oil glands along the rim of the upper and lower eyelids — was a safe and effective technique to allay the tearing and discomfort associated with subtype 4 (ocular) rosacea.1

"Probing is a nice adjunct to what we can offer patients to alleviate many of the dry eye symptoms that patients with ocular rosacea face," Dr. Wladis said.

In the study, five men and five women with rosacea underwent the procedure, in which thin probes are inserted to clear blockages in plugged glands. All reported improvement in their symptoms, and were able to decrease their use of artificial tears. No complications were identified in the six-month follow-up period.

The meibomian glands, the oil glands inside the eyelids, are typically affected in ocular rosacea patients and may often be blocked, causing instability of the tears that lubricate the surface of the eye, and a gritty granular sensation indicates damage to the ocular surface.

"It's important that anyone with significant symptoms of ocular rosacea make an appointment with an ophthalmologist, as potential corneal complications may involve the loss of visual acuity," Dr. Wladis noted.

In the journal Ocular Surface, Dr. Mark Mannis and colleagues reported a study of the properties of glycans, a type of molecule, in the tears and saliva of healthy individuals and those with rosacea.2 They noted that O-glycans were dramatically increased in the tears and saliva of those with rosacea, while healthy individuals had high amounts of N-glycans. The researchers said that the identification of high levels of this specific molecule in individuals with ocular rosacea may lead to the discovery of an objective diagnostic test.

Dr. Kevin Kavanagh and colleagues found a possible link between bacteria found on Demodex mites and the development of corneal ulcers in rosacea patients, according to a recent report in the scientific journal Investigative Ophthalmology and Visual Science.3

In the study, skin cells from the cornea were exposed to proteins from the Bacillus bacteria taken from a Demodex mite on the face of a rosacea patient. Demodex mites are microscopic parasites that are normal inhabitants of facial skin, but are often found in greater numbers on rosacea patients.

The researchers found that the exposed cells showed an increase in genes linked to an abnormal wound healing response, and noted that these findings suggest a potential connection between the high density of Demodex mites on the eyelashes of ocular rosacea patients and the development of corneal ulcers.


  1. Wladis EJ. Intraductal meibomian gland probing in the management of ocular rosacea. Ophthalmic Plastic & Reconstructive Surgery 25 July 2012 doi: 10.1097/IOP.0b013e3182627ebc.
  2. Vieira AC, An HJ, Ozcan S, Kim JH, Lebrilla CB, Mannis MJ. Glycomic analysis of tear and saliva in ocular rosacea patients: the search for a biomarker. Ocular Surface 2012;10:184-192.
  3. O'Reilly N, Gallagher C, Reddy KK, Clynes M, O'Sullivan F, Kavanagh K. Demodex-associated Bacillus proteins produce an aberrant wound healing response in a corneal epithelial cell line: possible implications for corneal ulcer formation in ocular rosacea. Investigative Ophthalmology & Visual Science 2012;53:3250-3259.