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Topics Discussed Below
- Introduction
- Basics of the eye
- Proper functioning of the eye
- References
I. Introduction
Ocular rosacea is a disorder
that affects both the eye surface and eyelid. Some of the most common
symptoms include: (1-6)
- Bloodshot eyes
- Hyper-sensitivity of the eye surface
- Foreign body sensations
- Excess tearing
- Eye irritation to wind, cold, smoke, indoor heating
- Burning sensations
- Eye pain
- Photophobia (pain and tearing of the eyes that is triggered
by bright light).
- Itching of the eye surface
- Redness, crusting, and inflammation of the eyelids. In some
cases, crust may form overnight and 'glue' the eyelids together.
- Chalazia (inflammatory bump on the eyelid)
- Stye (inflammation of an eyelash follicle)
- Excess discharge from the sebaceous glands of the eyelids
- Loss of eyelashes
- Severe damage to the cornea with blindness
II. Basics of
the Eye
In order to understand
the symptoms and causes of ocular rosacea, the reader must first
understand how the eye normally functions and protects itself. Under
normal conditions, the eye surface (ocular surface) is protected
and nourished by a 'tear film'. This tear film consists of three
important layers:
- An Oil Layer. This is the most superficial layer of the
tear film. Its main purpose is to smooth the eye surface and reduce
evaporation of tears. The oil layer is produced by meibomian (may-bo-mian)
glands, a row of sebaceous glands that run along the eyelid margins
on the inside of the eye lashes.
- A Water Layer. This is the middle layer of the tear
film that makes up the "tear portion". This layer moisturizes
and nourishes the front surface of the eye and lenses and washes
away foreign particles and irritants. This layer of water is produced
by lacrimal glands.
- A Mucous Layer. This layer, which lies against the surface
of the eyeball, is composed of mucous. Mucous allows the water
to spread evenly over the surface of the eye and helps the eye
remain wet. Without mucous, tears would not adhere to the eye.
Mucous is produced by goblet cells on the surface of the eye.
III. Proper
Functioning of the Eye
For proper function and
protection of the eye, all three layers of tear film must be normal.
If any one of these layers is abnormal, it can disrupt the tear
film and trigger uncomfortable eye symptoms. In many rosacea sufferers,
one or more of these layers is abnormal, causing disruption of the
tear film layer and ocular rosacea symptoms.
IV. References
- Akpek, E.K., A. Merchant, V. Pinar, and C.S. Foster. Ocular
rosacea: patient characteristics and follow-up. Ophthalmology
104: 1863-1867, 1997.
- Browning, D.J. and A.D. Proia. Ocular rosacea. Surv Ophthalmol
31: 145-158, 1986.
- Dahl, M.V. "Rosacea: red faces and adult acne, and red
faces". Skin Care Today 5: 1999.
- Chen, D.M. and D.L. Crosby. Periorbital edema as an initial
presentation of rosacea. J Am Acad Dermatol 37: 346-348,
1997.
- Driver, P.J. and M.A. Lemp. Meibomian gland dysfunction. Surv
Ophthalmol 40: 343-367, 1996.
- Barton, K., A. Nava, D.C. Monroy, and S.C. Pflugfelder. Cytokines
and tear function in ocular surface disease. Adv Exp Med Biol
438: 461-469, 1998.
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