Rosacea is a disorder of unknown origin that affects both the eyes and face, particularly the cheek area.  The irritation and redness is thought due to changes in the composition of oil from the face and along the border of the eyelids.  The facial problem may precede the eye problems or vice versa.  In some patients only the eye  or facial symptoms develop.

    Rosacea can flare with any physical or emotional stress.  Physical stresses include excessive exposure to sunlight, fatigue, alcohol, overworking, injury, or infection.  Treatment for this problem is outlined below:

    Facial Rosacea - Physical and emotional stress reduction plus oral Tetracycline derivatives or topical Metrogel are the main stays of treatment.  Most patients can be expected to note a very good response within two weeks.  Afterwards, intermittent use of medications is suggested.  Other useful antibiotics are Erythromycin and Clindamycin.  Full antibiotic dosing is usually prescribed for one month, with treatment with reduced dosing for 1 - 2 more months.

    Ocular Rosacea - This disorder is a bit harder to successfully treat.  Higher doses of oral Tetracycline derivatives are often indicated.  However, to improve the rate of success in treating this disorder, specific measures to open the oil gland pores are needed and these are listed below:

    Warm Compresses - Should be used as often as possible when symptoms are at their worst.  This is usually 3 - 4 times daily.  Hold the warm compress against the closed eyes, then re-warm the compress as it cools.  5 - 10 minute treatments are recommended, twice daily initially.  Compresses should be immediately followed by eyelid scrubbing for optimal benefit.

    Eyelid Scrubbing - Baby shampoo has been the most commonly recommended product.  A slightly soapy solution can be formulated in a in a shallow bowl and, with the eyes closed, each closed eyelid is gently scrubbed for 30 - 60 seconds.  An alternative prescription eye wash and can be ordered through your pharmacy.  The ocular program noted above should be followed twice daily until improvement is noted.  Then, treatments are reduced in frequency to as needed.  In some cases of ocular Rosacea, eye treatment alone may be effective, without the necessity of oral medications.

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