Rosacea eye: what to do?
Rosacea of the eye is an erythema that spreads from the face to the organs of vision. The disease is characterized by damage to the cornea, iris, eyelids and conjunctiva. Rosacea of the eye has a chronic course and accompanies the cutaneous form of rosacea in 30% of cases. The disease is most often bilateral in nature.
The anterior tissues of the eye during the intrauterine development of the child are formed from the same germ layer as the skin. Therefore, they are characterized by similar pathologies. But since the eyes have a higher sensitivity and innervation, their inflammation is very noticeable for the patient.
Rosacea typically affects people between the ages of 40 and 60, although it can also occur in children.
You cannot ignore the disease. If left untreated, rosacea can lead to complete blindness.
Content:
- Causes of eye rosacea
- Rosacea eye symptoms
- Diagnostics of the eye rosacea
- Rosacea eye treatment
- Prevention and prognosis
Causes of eye rosacea
The reasons for the development of rosacea of the eyes can be distinguished as follows:
- Alcohol abuse and smoking. These bad habits contribute to capillary damage, disrupt their normal tone, and lead to stagnation. All this becomes favorable factors for the manifestation of the disease.
- Frequent visits to the solarium, prolonged time in the sun without using eye protection. Ultraviolet light triggers a number of pathological reactions that damage the vessels of the skin and the intercellular substance, provoking the development of rosacea of the eyes.
- Sudden temperature changes.
- A relationship has been established between the development of eye rosacea and diseases of the digestive system.
An indispensable condition for the occurrence of a pathological process in the organs of vision is the presence of rosacea on the skin of the face. The inflammatory process leads to the transmission of blood vessels through the epidermis and severe erythema. Venous outflow suffers, blood stasis is present on an ongoing basis, which is the basis for the development of rosacea of the eyes.
Disturbances in the work of the meibomian glands cause instability of the tear film, excessive evaporation of tear fluid, and the formation of dry eye syndrome. All of these become key mechanisms in the development of the ocular form of rosacea.
Scientists have tried to establish a connection between the disease and infection with an eyelash mite, however, it was not possible to trace it. However, Demodex follicularum is common in patients with eye rosacea.
Rosacea eye symptoms
Ophthalmic rosacea symptoms are most often mild, although it all depends on how severely the eye is affected. When the disease is just beginning to develop, the patient complains of pain in the eyes, increased lacrimation, and a burning sensation. It is possible that there is a feeling that a foreign body is constantly present in the eye. Visual acuity can suffer already in the early stages of the development of the disease.
The conjunctiva and whites of the eye become bloodshot, swollen and red. During a visit to the ophthalmologist's office, the doctor visualizes telangiectasias of the edges of the eye, persistent inflammation of the eyelid, and the presence of chalazions in the thickness of the eyelids.
For a long time, a person may unsuccessfully try to treat conjunctivitis.
The ducts of the meibomian glands are sometimes blocked with yellow plugs. If you press your finger on the edge of the eyelid, then a thick opaque secret will stand out from the duct. Sometimes it looks like a gruel.
As the cornea is damaged, keratitis and the proliferation of blood vessels into the stroma of the cornea itself are observed. At this time, vision drops sharply, up to complete blindness. Vessels on the eye resemble twigs. This stage of the development of the disease is characterized by the addition of cutting pains, pronounced photophobia. Ulcers and infiltrates may appear on the cornea.
Ignoring the symptoms of ophthalmic rosacea leads to the development of serious visual complications. The most dangerous of them are phlyctenular keratoconjunctivitis, neovascularization of the cornea, peripheral keratitis, conjunctival fibrosis, ulcerative scleritis.
Diagnostics of the eye rosacea
Diagnosis of eye rosacea begins with a routine examination of the patient. The doctor assesses the patient's visual acuity, conducts biomicroscopy and tonometry of the eye. It is imperative to interview the patient in detail, to clarify whether there was a cutaneous form of rosacea in the anamnesis.
As for additional examination methods, it is possible to carry out the Schirmer test and the Norn test. They allow you to determine the stability of the tear film and the quality of tear production.
During the examination, it is necessary to carry out a differential diagnosis with dry eye syndrome, allergic and toxic conjunctivitis.
Rosacea eye treatment
Most often, the treatment of eye rosacea is not difficult. Only in the case when the disease has a running course, a long therapeutic course may be required. To prevent this from happening, you should seek help from an ophthalmologist already in the early stages of the development of the disease. In addition to the main treatment, symptomatic therapy is carried out.
Gel with Metronidazole
Rosacea of the eye, accompanied by demodicosis, requires the use of drugs based on Metronidazole. With ophthalmic rosacea, the parasite is found in the ciliary bed in 90% of cases. It is not difficult to identify it, it is enough to conduct a standard microscopic examination with a collection of eyelashes from both eyelids.
The following drugs can be used to eradicate the parasite:
- Demalan ointment.
- Stop Demodex gel.
- Gel Metrogyl.
The duration of treatment and the choice of medication should be determined by the doctor. If the drug was selected correctly, then the inflammation process will fade away, and the control microscopic examination will not find traces of the parasite in the ciliary bed.
Topical antibacterials
If rosacea of the eye is accompanied by the addition of a bacterial infection, then the patient is prescribed antibiotics. The bacteria that provoke skin inflammation in rosacea easily colonize the mucous membrane of the eye and conjunctiva. Therefore, bacterial conjunctivitis is a frequent companion of eye rosacea.
To get rid of inflammation, you will need to use the following drugs:
- Eye drops: Ciprofloxacin, Ofloxacin, Tobramycin.
- Ointments: Erythromycin, Tetracycline.
These drugs have a wide range of antibacterial activity and can cope with most microorganisms that affect the mucous membrane of the eye. When the ongoing therapy does not give the desired result, it becomes necessary to perform an antibioticogram. This study allows you to identify to which drugs the pathogenic flora is sensitive. Then the patient is prescribed a second course of local antibiotic therapy.
Moisturizing the mucous membrane of the eye
Dryness of the mucous membrane of the eye is one of the common symptoms of rosacea. Insufficient hydration is caused by disturbances in the work of the meibomian glands, which overlap due to a number of factors (edema of the mucous membrane, parasitism of ticks, hypertrophic changes in the skin of the eyelids). As a result, the tear fluid quickly evaporates from the surface of the eye, provoking dryness. To get rid of this phenomenon, you must use special moisturizing drops. They need to be installed until rosacea is completely eliminated.
These drugs include:
- Oxial.
- Systein.
- Hilo chest of drawers.
Stimulation of metabolic processes
Natural metabolic processes that occur in the organs of vision are impaired in rosacea, since chronic inflammation is present. Any defects and injuries of the eyelid and conjunctiva take longer to regenerate, which negatively affects the patient's well-being.
To normalize metabolic processes, you need to use drugs such as:
- Emoxipin.
- Solcoseryl.
- Taufon.
Removal of inflammation
If you do not get rid of the inflammation, then the person will experience severe discomfort. During an exacerbation of the disease, the use of hormonal drugs is permissible. However, only a doctor can prescribe them, having evaluated all the benefits of the treatment. Preparations with a hormonal component are used for several days, but not too long.
To eliminate a chronic inflammatory reaction that is not associated with the risk of developing serious complications, you can use the following drugs:
- Indomethacin (Indocollir).
- Diclofenac (Diclo-F).
- VisiDoll.
Disinfection of the skin around the eyes
To treat the skin around the eyes, ointments and creams with an antibacterial component are used. It can be Tetracycline or Erythromycin. They should be used from the very beginning of the therapeutic course. This is an excellent prevention of bacterial infection and other complications. In complex therapy, it is possible to use decoctions and compresses based on medicinal herbs.
Laser therapy for eye rosacea is rarely prescribed. The laser can be used to eliminate a cosmetic defect and remove the hypertrophied layer of the eyelid skin. The decision on the need for laser therapy is made by the doctor.
Prevention and prognosis
If the patient observes all the appointments of the ophthalmologist, then the prognosis for recovery is favorable. Although in some cases, treatment lasts for several months.
To prevent the development of ophthalmic rosacea, you should minimize the impact on the eyes of negative factors. All people over 45 need to be examined by an ophthalmologist every year. Basic recommendations boil down to maintaining a healthy lifestyle, giving up bad habits, and exercising regularly. All diseases of the digestive system must be treated with high quality. If the inflammation of the skin of the face with rosacea is stopped in time, then the disease will not spread to the organs of vision.
The author of the article: Degtyareva Marina Vitalievna, ophthalmologist, ophthalmologist
