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Ocular rosacea

Anthony Bron, FRCOphth, FMedSci
Section Editors
Mark V Dahl, MD
Jonathan Trobe, MD
Deputy Editor
Abena O Ofori, MD


Rosacea is a common and chronic disorder that is divided into four main subtypes based upon clinical manifestations. Ocular rosacea refers to disease that involves the eyelids and anterior globe. Erythematotelangiectatic, papulopustular, and phymatous rosacea are subtypes that affect the facial skin [1,2].

The inflammatory, vascular, and glandular abnormalities that occur in ocular rosacea can result in blepharitis (inflammation of the eyelid margin), conjunctival hyperemia, dry eyes, rosacea-associated keratitis, and ocular discomfort. Although most patients with ocular rosacea present with concomitant cutaneous lesions, ocular involvement is the initial manifestation of this disease in a minority of patients.

The clinical features, diagnosis, and treatment of ocular rosacea will be discussed here. Cutaneous rosacea is reviewed separately. (See "Rosacea: Pathogenesis, clinical features, and diagnosis" and "Management of rosacea".)


Similar to cutaneous rosacea, ocular rosacea primarily affects adults, but the disorder may occasionally occur in children [3-9]. In a retrospective study of 131 affected patients, the average age at presentation was 56 years [8]. Unlike cutaneous rosacea, which exhibits a strong female predominance, the sex distribution of ocular rosacea is fairly even [10-13]. (See "Rosacea: Pathogenesis, clinical features, and diagnosis", section on 'Epidemiology'.)

The estimated risk for ocular disease among patients with cutaneous rosacea has varied widely, with reported prevalence rates ranging from less than 10 percent to more than 50 percent [7,9,11,14,15]. Evidence is insufficient to conclude whether specific features of cutaneous rosacea are associated with increased likelihood for the development of ocular disease. However, some authors have proposed that ocular involvement may be more likely to occur in patients with a propensity for flushing [11].


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Literature review current through: Aug 2017. | This topic last updated: May 25, 2017.
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