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

What Your Eyes May Be Telling You

For many people, eye irritation isn’t just a symptom of allergy season. It is ocular rosacea, a subtype of the disorder that can potentially be very serious if allowed to become severe.

Found to affect up to 60 percent of rosacea patients in surveys by the National Rosacea Society, subtype 4 (ocular) rosacea often results in a watery or bloodshot appearance, as well as irritation and burning or stinging of the eyes. In addition, the eyelids may become swollen, and styes are common. Many patients report feeling a gritty sensation, as if there’s a foreign body in their eyes. Blasts of cold air in winter may also cause a watery discharge, another possible symptom.

A medical study of ocular rosacea patients found that 85 percent had meibomian gland dysfunction.1 The meibomian glands line the edge of the eyelid and secrete a fatty substance that helps keep the eye from drying out. Plugging of these glands may result in dry eye, styes or chalazions (a type of benign cyst).

Since most people do not associate eye discomfort with a skin disorder and the symptoms are usually mild, many rosacea patients may not recognize that they suffer from the ocular as well as the facial manifestations of the disorder. Severe ocular rosacea, however, can pose significant consequences if left untreated, including corneal damage and the development of additional blood vessels in the cornea, a condition known as corneal neovascularization. Both conditions may result in reduced visual acuity.

Research continues to uncover more information on this rosacea subtype that can lead to better diagnosis. In one recent study, researchers found differences in the properties of glycans, a type of molecule in the tears and saliva, between rosacea patients and healthy patients.2 Another study that examined the eyelashes of 38 ocular rosacea patients found the presence of bacteria associated with Demodex mites, and noted that the patients may have been affected by a reaction to the proteins produced by the bacteria, a possible reaction to the mites themselves or colonization by other microbes.3

Be sure to let your dermatologist know of any eye symptoms you may experience, and rosacea patients with substantial eye symptoms are advised to see an eye doctor. In some cases, the eyes may also serve as a warning sign of things to come.


1. Ghanem VC, Mehra N, Wong S, Mannis MJ. The prevalence of ocular signs in acne rosacea: comparing patients from ophthalmology and dermatology clinics. Cornea 2003;22:230-233.

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. Li J, O'Reilly N, Sheha H, et al. Correlation between ocular Demodex infestation and serum immunoreactivity to Bacillus proteins in patients with facial rosacea. Ophthalmology 2010;117:870-877.