Why rosacea can also affect the eyes

The causes behind rosacea have not been definitively established. However, various triggers are suspected:

• genetic predisposition
• Demodex mite infestation-
• foods such as dairy products, sugar, alcohol and spicy foods
• stress and mental strain
• cosmetics
• environmental influences such as wind, cold and UV rays
• vasodilatory medicines

Various tests can be used to find out what the body reacts to in particular. Often, the symptoms improve as soon as the trigger is avoided.

With this condition, the blood vessels of the skin on the face dilate, which is why rosacea manifests as extensive redness on the forehead, cheeks, chin, nose and sometimes the eyes. Typical symptoms include:

• red blotches
• papules (nodules) and pustules
• visible blood vessels
• sensitive skin
• dry skin
• flaky skin
• itchy skin
• inflamed eyes

Depending on which symptoms appear on the facial skin, where they occur and how pronounced they are, rosacea is divided into four types:

• Type 1: The face is slightly red, fine veins are visible through the skin.
• Type 2: In addition to the reddened facial skin, pustules or small nodules form.
• Type 3: Thickening of the skin with the formation of inflammatory nodules, especially around the nose.
• Type 4: The eyes and eyelids are inflamed, and swelling forms at the edges of the eyelids.

However, rosacea is often overlooked as a possible cause of dry eyes and red eyelids.

In about half of all rosacea sufferers, the skin condition causes eye discomfort. Referred to as ocular rosacea, this occurs exclusively on the eyes and eyelids in some people, while others have symptoms in the eye area in addition to the redness on the face, such as

• foreign body sensation
• burning eyes
• red eyelids
• dry eyes
• watery eyes
• swollen eyelids
• crusty eyelid margins
• sensitivity to light
• blurred vision

The chronic inflammation of the eyelid skin caused by rosacea can lead to a constriction or even a blockage of the sebaceous glands (meibomian glands) located in the eyelids. The function of these sebaceous glands is therefore disturbed, and a meibomian gland dysfunction can occur. At the same time, the production of tear fluid is usually impaired. Rosacea causes insufficient tear fluid to be produced and the eyes dry out prematurely, becoming red, burning and itchy. In the long term, eye dryness can lead to conjunctivitis, scleritis, keratitis and other diseases.

You can alleviate the acute discomfort of the eye through various measures:

• Avoid triggers: Since rosacea can have many different causes, the first step is to find the trigger. If the redness is caused by certain cosmetics, environmental influences or diet, these triggers should be avoided.
• Eyelid margin hygiene: Careful eyelid margin hygiene forms the basis of the treatment, with regular cleaning and care of the eyelid margins. The effect of heat loosens the accumulated sebum in the glands, which can then be removed more easily with a damp cotton pad or eyelid hygiene wipe.
• Moisturisation: To protect the eyes from drying out and to avoid possible inflammation, it is recommended to moisturise them with eye drops several times a day.
• Medications: In addition, treatment with antibiotics or anti-inflammatory drugs such as ciclosporin is usually given to relieve the acute symptoms.

Even in the long term, the triggers should be avoided, and the eyelid margins should be cleaned and cared for to alleviate renewed discomfort.