Ocular Rosacea:
Eye Basics and Proper Functioning of the Eye

 

Topics Discussed Below

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• Introduction
  
• Basics of the eye
  
• Proper functioning of the eye
  
• References
  

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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

1. Akpek, E.K., A. Merchant, V. Pinar, and C.S. Foster. Ocular rosacea: patient characteristics and follow-up. Ophthalmology 104: 1863-1867, 1997.
   
   
2. Browning, D.J. and A.D. Proia. Ocular rosacea. Surv Ophthalmol 31: 145-158, 1986.
   
   
3. Dahl, M.V. "Rosacea: red faces and adult acne, and red faces". Skin Care Today 5: 1999.
   
   
4. Chen, D.M. and D.L. Crosby. Periorbital edema as an initial presentation of rosacea. J Am Acad Dermatol 37: 346-348, 1997.
   
   
5. Driver, P.J. and M.A. Lemp. Meibomian gland dysfunction. Surv Ophthalmol 40: 343-367, 1996.
   
   
6. 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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