@Nancy Jane It is hard to say without doing an eye exam. If you haven't done this already, you can always supplement your current treatments with preservative-free artificial tears. If that does not work, I would ask your doctor if you would benefit from medicated treatments. I hope you find some relief 🙏
I have Ocular rosacea and it took about 4 years to get that diagnosis. I have very dry sensitive eyes and was put on Xiidra on my first appt. That was an unhappy journey, thinking it was helping because I got a smidge better, but my eyes were always hurting, vision off, headaches, red eyes. Finally got off xiidra a month ago with the help of Eyesuvis which is an amazing short-term flare up steroid, and I am on number 5 of my IPL treatments. I see an Ophthalmologist (who knew immediately by looking that is what I had) that does IPL dry eye and if actually goes over my lids and it has been the BEST thing. My eyes are so much better with very little swelling on my lid margin. It is a shame it is not covered by Ins as it is expensive. I will probably have to do this for ever hopefully only a couple of times a year after this initial course. Of course, like you mentioned you are told to apply heat heat sometimes 2x a day, I did this for 3 years and my lids were always so red, and I believe all that heat has damaged the delicate skin around my eyes making me look older. The heat never made the oil come out any better, every appt it was the same, toothpaste and not coming out enough etc etc. I do the IPL and now there is oil coming out. I do not think heat is the best for Ocular rosacea and have almost stopped doing it. Hope this can help someone. PS I did not know I had it on my face as I had infrequent flushing but once in a while when i got hot my cheeks and nose would get red and now, I know it is rosacea. I can wear a bit of makeup now ))))
Thanks for sharing your experience! Ocular rosacea is severely underdiagnosed and unfortunately requires a different treatment algorithm than other types of dry eye. I'm so glad you were properly diagnosed and able to get relief with IPL and topical steroids ❤
I want to get ipl so bad but I can't find a specialist in my area. My eyes are miserable. I've already tried plugs restasis and steroids. I think the heat is more harmful than helpful as well but every doctor I see keeps insisting I do it.
@@ktstone1443 I'm so sorry you are having a hard time finding a specialist in your area :( If your eyes feel worse with heat application, I would urge you to stop for a bit and see how your eyes feel. I can't speak for your eyes without seeing them, but if you have rosacea, heat is a common trigger. Also, sometimes doing less for a while can help your eyes reset so you can see what treatments are actually effective for you. I hope you get some relief soon ❤
Same story exactly for me, going on almost 6 yrs now. I had my first IPL treatment today so I’m excited and hopeful. Very expensive, I’m paying $1800 out of pocket for 4 treatments. It’s crazy that insurance doesn’t cover this painful and very life disrupting condition. I agree also that warm compresses makes it worse.
My doctors wouldn't dx ocular rosacea at first. They just gave me the standard MGD diagnosis telling me to put warm compresses on my eyes several times a day plus dry eye drops. It was terrible. I realized that warm compresses were either too warm and exacerbated my rosacea or they weren't warm enough and did nothing for my dry eyes. After a little research I found out that ocular rosacea was a thing and made the connection with the redness of the lower lid and sometimes seeing papules and pustules in the lash line. I started using a manuka honey eyedrop that really helps with the inflammation of the lower lid. I take omega 3 oils every single day. I'm actually being treated for SIBO. Finally, I went to the dermatologist and somehow got them to give me a prescription for topical ivermectin cream which wipes out demodex. Another game changer. Unfortunately, IPL isn't available to me due to cost and my medical clinic doesn't offer it. Also thank you for the tip about steroid eyedrops not being a long term solution.
Hi Michele, Dr Bill Marrocco here. I'm a retired Plastic Surgeon currently practicing Wellness Medicine. I was dx'd w/ ocular rosacea (OR) this summer. Responded well to doxy, but with intolerable GI consequences. Stopped doxy and started cyclosporine bid. I just started, so still too early to appreciate efficacy. I'm planning a different approach. I now treat many patients with autoimmune disorders. Instead of suppressing the immune system, I use Low Dose Naltrexone (LDN) to reset it. Since OR has an autoimmune component, I'm going to give LDN a shot. If I enjoy improvement, I'll let you and my Ophtho know. If it does show promise, I think i'll opt for IPL and stay on LDN to prevent flares. Great video, I love your delivery.......very informative, articulate, precise and concise. Thank you!
Hey there Dr, how is the Low Dose Naltrexone going? Just heard of this being used for gut motility ( I have SIBO issues , bloating and constipation, and ocular rosacea). Any update is appreciated, thanks!
So interesting! I know a few people whose long covid symptoms have improved so much with low dose naltrexone. What is the mechanism of action for low dose naltrexone helping disorders that affect the immune system?
My doctors can’t figure out what’s going on with my eyes, but recently someone through ocular rosacea out there as a possibility. Thank you for the helpful information!
I didn't know a person could get rosacea in the eye area? I was diagnosed with adult rosacea a few years back, its not as bad now, but I did have the tiny white bumps on the right side of my face, mostly, some eye flare ups with frequent styes, not as much now... at certain times of the year I will experience that dry eye deal for a week or two, then it goes away for months, but had no idea it was the rosacea? The dermatologist I saw prescribed a few different creams and the eye doctor, eye drops which didn't really work. I am glad its pretty much under control, but the flare ups are irritating as you can imagine. Thanks for this....
Thanks for sharing your rosacea journey! Agree that rosacea flares are very irritating, and I hope you are able to get a handle on your rosacea and dry eye ❤
I have diagnosed with Ocular rosacea for the past 4 months, it is not fun. All information for treatment and reduce flare ups is so useful. Thank you for sharing on this topic.
Thank you for your video. I was just put on doxycycline mono50mg capsule for 30 days twice a day. I get burning of the eye,tearing,itching of the eyelid. Every so often I wake with blurred vision sore eyes,and have anxiety that I may not be able to see clearly again. Vision returns and I am relieved. Not sure if this is related to ocular Rosacea or severe dry eye,it rarely happens.
Thank you for sharing your experience. It's hard to say whether your symptoms are due to rosacea or another cause of dry eye. WIthout knowing what your eye looks like, I can only advise lubricating with preservative-free tears when your vision is blurry or your eyes are irritated and seeing your eye doctor if you are really struggling. Hope you feel better soon ❤
I went to my ocular doctor and he is supposed to be very good and able, told me I “ have nothing “ , that I should be grateful , but I do have all of those symptoms
Hi, I have had rosacea since I was born and after a hysterectomy (which has made it full blown and constant) it seems to get more difficult to explain to friends and family why you don't feel good or why you can't join them for wine and spicy dinners. It's really a challenge to have a good "quality" of life. I thought I was just rare & I get depressed, so thanks for your video! ❤
I have Ocular Rosacea. I use lumify and dry eye preservative free drops. The best thing that has helped me is Manuka Honey eye drops 3x a day, Manuka Honey gel, Dry eye drops, lumify for any redness and a oral capsules or Oil of Oregano. This combo finally calmed down my eyes. It was getting so bad nothing was helping except lumify several times a day. I am a "responder" to steroid eye drops and my pressure went sky high so I couldnt take those. Now I can get away with lumify twice daily max sometime I do not need it at all. I was washing my eyes with a tea tree oil wash and doing warm compresses, the above combo mentioned was what ended up helping me.
Great protocol! I am also using the manuka honey eyedrops for my ocular rosacea. That and daily doses of omega 3 oils which has been a game changer. The Omega 3 oils make me feel like I don't have ocular rosacea.
@@puggirl415 how much Omega 3 do you take a day? I take 2000 but I still have symptoms. Do the Manuka honey eyedrops sting a lot? I often wonder why no Dr's mention them yet a lot of people seem to have success with them
Yes! I had SIBO and the rosacea went away when I changed my diet till the SIBO went away. I'm so glad you brought this subject up. Most people with rosacea do not know about this!!!❤
@@MicheleLeeMD I have to find a dermatologist, first. But, do you know if there are any optometrist/opthalmologist who specialize in ocular rosaceae in the Denver area? Thank you in advance.
@@kbutcher I do not have any personal recommendations. If you look up "ophthalmologist denver dry eye" on google, a few practices pop up - the top hit looks very legitimate. Hope that kind of helps, and best of luck!
Yes, I’m pretty sure I have ocular rosacea! I have had IPL a number of times on my face and neck a number of times to control the redness. I have flares when my cheeks are bright red. In the last year, I have times when my eyes felt gritty and my eyelids were red and itchy. I was treated with a topical steroid on my eyelids for a month and then gradually tapered the dosage. I still have to use the steroid occasionally on my eyelids.
Dermatologist had put me on doxy- was on it just about a year- it did nothing for my eye lids but sure tore up mu stomach! So far Restatis, and any topicals they have tried is not working! So frustrating and so tired of the burning etc. Ice packs do help but only while they are on. Thx for the great video! I’ll be looking very closely at food/drink triggers!
I was recently diagnosed with ocular rosacea. I was already being treated for facial rosacea and my dermatologist recommended I see an ophthalmologist since I was having a lot of trouble with my eyes. I am newly into the treatment regimen (drops, ointment and an initial run of antibiotics), and I am seeing some improvement already. (It's only been about a month.) I am interested in IPL. I plan on asking my doctor about it.
Interesting video TY! I have eye dryness and double vision in left - say I need muscle surgery. Just a few days ago I developed odd inflammation on my nose and check. Derm doc today said it’s rosacea. My checks have been red since childhood. Had lots of sun - too much. Flush if embarrassed. I love heat in the form of hot tub and sauna!!! OMG do I need to stop? I own both!!! I live in SoCal so summer is coming. I am terrified at the moment listening to this video. I’m in my mid 70s. Thx if you can give input.
I was just diagnosed, looking back it’s been there a long time. I got use to the burning as it comes on gradually. I am working with a dermatologist for my skin and they are staring me on low dose doxy. I can’t believe my eye doctors did not catch it, do you have videos where you perform IPL?
I don't have an IPL video to share but there are some good videos out there on UA-cam about IPL for the eyes. Here are two videos I like: ua-cam.com/video/v8TbYijQs2s/v-deo.html (Eye School with Dr. D) ua-cam.com/video/4AvhT9fFcAk/v-deo.html (Doctor Eye Health) Not everyone does IPL for ocular rosacea, this is usually done by an ophthalmologist or optometrist with a special ocular protocol. Hope this helps!
Very helpful video! I have been diagnosed with ocular rosacea and found that the hot compresses recommended for dry eye were definitely a trigger. My doctor hasn't mentioned IPL but it sounds promising. Thank-you for the information!
I was recently diagnosed with dermatological rosacea. Just prior to diagnosis I had a stye and every morning, I wake up to crusty eyes. I don't have terribly red eyes or lids, but the constant crustiness, dry, gritty eyes is bothersome. I did not know ocular rosacea was a condition until I was reading about rosacea, but now I'm wondering if I have that as well.
Hello Dr found the presentation excellent,was diagnosed with Roscea some months ago male 52 yoa it started with the spots, I was aware of the ocular version which,in the printout the doctor gave me stated you could lose your sight with this condition. I have had the gritty and sore eyes and now am wondering have i got it in my eyes,just finished long course of doxyceline and rosex cream,now terrified my sight will be effected or worse still lose it. I know i cant go on the antibiotic long term but this is making me very Anxious. I have contacted the doctor again to see next steps.Again excellent presentation thank you.
Thank you for this video. I have mild rosacea and recently my eyelids began swelling and itching. I just don't know if it is eye lid eczema or rosacea. How can I tell?
Thank you for your video! I've always had redder cheeks than most all my life & suspected I had rosacea. It was over 18 months ago that it sort of exploded with more redness, some pustules & itchiness on my cheeks & around my eyes. The eye doctor diagnosed dry eye & prescribed Metronidazole cream to add to cleansed face twice a day. He also prescribed Restasis, but there is no way I can afford that! Funny, but the term occular rosacea was not used. So, can one have both dry eye & ocular rosacea at the same time? I'm not sure if heat is a trigger, but caffeine might be & for sure, sugar & chocolate are my biggest triggers! It's hard to cut down when you're a sugar/chocoholic! I do use preservative free natural tears eye drops, but I go through them pretty fast. Other than cleaning up my diet, I don't know what else to do.
That sounds like ocular and facial rosacea to me (but of course, I haven't examined you myself to confirm!). I would ask your eye doctor if steroid eye drops or IPL would be helpful for your dry eye symptoms, of which ocular rosacea is most likely contributing. Hope this helps, and best of luck!
Hi Lynn, most of the time ocular rosacea does not cause severe long term effects or cause permament loss of vision, though the symptoms are uncomfortable. Here are a couple things I have seen with chronic and severe ocular rosacea: 1) Atrophy and distortion of the eyelids (lid notches, misdirected eyelashes, loss of eyelashes) 2) Scarring and vessels on the cornea (the clear avascular layer in front of the eye) Hope this helps and thanks for your comments!
@@MicheleLeeMD yes, I have had problems described in #1. I am surprised that no one caught it earlier. I am on Oracea now. It’s been about a week, my eyes no longer burn and the inflammation is really decreased. This med seems to be drawing out the plugged gland and I have 6 small styles all at once. Assuming these will clear. I admit I gradually got use to burning being somewhat unnoticeable it happen so gradually. Sad, it’s missed so often. I will look into IPL and may come to Scottsdale to do it. Thank you
Hi I am having a flare up of ocular rosacea. I am taking 4 kinds of eye drops/gel. I stopped wearing makeup but still using my eye cream. I am 63 yrs old and was using retinol for eyes every night which I stopped. I am trying to find concealers and anti aging skincare that won’t damage my eyes. Can you help me?
Liked and subscribed. I have rosacea, and my cornea doctor thinks I might have ocular rosacea. Just had the epithelial layer of the cornea removed followed by diamond burr polishing. It's taking longer to heal than anticipated, but I'm looking forward to having a healed eye!
Hi Emily, usually not but if you have severe ocular rosacea for a long period of time, there can be alterations of the eyelid margin (lid notches, loss of eyelashes) and cornea scarring. Mosf ot the time, these changes are only visible under a microscope, but rarely this can affect vision or cause permanent problem to the eyes. Hope this helps!
It's really tricky. Rosacea typically affects adults more often and is mostly on the mid-face. If you aren't sure you might need to see a dermatologist since the papulopustular form of rosacea can mimic acne. Thanks for your comment!
Where are the doctors that have the protocol for treating O.R.? I have a dx of it - have tried warm compresses - they cause a flare for me, steroid eye drops - didn't make much of a difference, refresh artificial tears and Cequa help some, Doxy helps some, I am still having a lot of trouble with my eyes - where are the most experienced IPL doctors?
Hi there, I would ask your eye doctor who does IPL for ocular rosacea in your area. She/he will probably know who the local IPL people are. Thanks for sharing your ocular rosacea journey with us and I hope you are able to get some relief soon!
This video was so informative. I just went to my dermatologist and asked about dark circles and he said there was no cure. However after viewing this video I think it's related to my Rosacea. Have you any experience with cool compresses for the eyes?
Thanks for your feedback. Cool compresses can help to a degree in helping constrict some of the vessels. Sometimes too cold might be an irritant as well, so don't overdo it!
Hey Claudia, dark circles under eyes could also be lack of iron, kidney issues, fatigue. I have it too. Mine are more kidney related due to stress. And severe ocular rosacea. Take care.
Hi Cantherine, that is a great question. There is no correct answer. When I see patients who responded well to doxycycline in the past with minimal side effects but are having a flare of rosacea, I would advise they go back. I try to do only a 3 month course at a time but I have a few patients who are on a lower dose for an indefinite time. The decision to continue doxycycline or to go back on it is completely dependent on your symptoms and your response to the medication. Hope that helps, and thanks for your question 🙏
That's a fair concern. Make sure you are discussing side effects like eye pressure and possible cataracts if taken long-term with your eye doctor. Hope that helps!
Thanks for watching! Ocular rosacea can definitely cause burning as a symptom, and chronic inflammation of the eyelids can result in lash loss. Hope that helps!
I have it. I have had rosacea for over 15 years as a teenager and since having my daughter it has spread to my eyes and it’s on my face horribly as well along with acne like bumps
I've been diagnosed with ocular rosacea but only have slightly inflammed water lines - is that inline with it? and should I really not be hot compressing?
Hi there, it might be rosacea. It is hard to know for sure unless there are lid margin telangiectasias and other classic findings on our slit-lamp examination (hard to see this level of detail without a microscope). If you sometimes get a pinkish rim on your water line, it could be ocular rosacea, but I would ask your eye doctor if you aren't sure. Warm compresses are really dependent on the person. Some with rosacea who don't have heat as a trigger find relief with warm compresses since it does open up the oil glands and help stabilize your tear film, but many people with rosacea will flare as heat is a major trigger of rosacea in general. Without knowing your eyes or history, I would say that if you have found that warm compesses are helpful for your symptoms, I would continue them. But if you don't feel a difference or if it seems to make your eyes and eyelids irritated afterwards, I would stop or ask your eye doctor.
@@lynnlind297 It's on the eyelid margin - where the skin and the conjunctiva (the clear vascular layer that lines the white part of the eye and inner eyelids) meet.
Hi, (a) I get relief from itchiness by squeezing my eyes tight then opening them wide repetitively for a minute or so. Is that bad or good for ocular rosacea? (b) Is eye-bathing with weak salt water beneficial?
Hi there, closing your eyes can definitely help with dryness since it will give your eyes a chance to lubricate with your natural tears. I don't recommend bathing your eye with tap water since there are so many parasites and bacteria in the water, but you can use preservative-free tears (sterile salt water) to wash out your eyes. Hope this helps, and thanks for your comment! 🙏
What about Blink, which does have a preservative but apparently it dissipates once the drop comes out of the bottle. Do you think this is one is OK for eye rosacea? Thanks ❤
You did not mention SD ocular rosacea. Imy diagnosis changed very quickly frm blepharitis and rosacea and atopic dermatitis to SD of skin and SD ocular derm. Finding an MD to treat this is difficult. Seems to me dermatologists dont want to touch it and pass it off as demodex or worse act as if nothing else. After 3 years of searching i think i have found an opthamologist who is well educated and young who is helping me. He believes i have a systemic infection or fungal or an allergy that is worsening this. Until we get to the root of this i am on doxy for 3 months plus alternating Claratin and and Zyrtc every other week. What do you thing? Most frustrating thing i have ever been through.😢
I have had a swollen upper eyelid for three years only on right eyelid. I have been to dermatologists, opthalmologists most of whom have no answers beyond steroids and antibiotic, which I refuse to use. All articles I read on ocular rosacea say there is itching or pain or irritation. I have none of that, only the swelling which sometimes swells around and beneath the eyes (bags) and also swelling of cheekat only on that one side. I'm not sure it is ocular rosacea and not all the doctors agree on that either. This is so very frustrating. I am on one blood pressure med and this swelling happened about 3 months after that - could this be caused by a medication? Thanks for any info or guidance.
I have ocular rosacea but for now I treat it with local antihistaminic drops : is this bad or not good enough ? It helps to reduce the symptoms... (I had first tried antibiotic cream but didnt help). Also I read about local Metronidazole eyedrops... Could it be useful!?
What percentage of ocular rosacea is caused by Demodex mites? I have dry eye, ocular rosacea and Demodex Blephartis. I'm taking the 6-week twice a day Xdemvy eye drops, and by my 3rd week my headaches were gone, and my eyes are clearer and not as red, and I can open my eyes in the morning without help. It's my understanding that the smaller mites (D. Brevis) live in the Meibomian gland and clog it up so it can't make tears as it's supposed to. There has to be a reason for rosacea and from what I've read most people have an overpopulation of Demodex. Can you respond to this? FYI, I'm using tea tree oil, which seems to be the only thing that can kill the mites.
I was diagnosed with skin rosacea this week. But had large stye on lower lid which my ophthalmologist treated a month ago with tobradex and compresses. A month later i have one on upper lid. Should i ask for oral antibiotics? Since it seems to be recurrent
I got diagnosed with Ocular Rosacea after seeing 5 doctors. I am on my 4th IPL treatments. My eyes still feel miserable. I do the warm compresses a few times a day. I was told to do this but I am thinking maybe it makes it worse. Should I do cold compresses instead?
My right upper eyelid gets red & sometimes swollen. My dermatologist prescribed tacromilus. It calms it down but will flare up again from time to time. Is this ocular rosacea or blepharitis ? Any better way to cure ?
It's hard to say - if your dermatologist prescribed tacrolimus do you have eczema/atopy? If so, this may not be rocacea but atopic keratoconjunctivitis which is part of the atopy spectrum. My advice is to see a dry eye/cornea specialist who can properly diagnose and treat you. Hope you get better!
Do you have (or think you have) rosacea? Let me know in the comments, and thanks for watching!
@Nancy Jane It is hard to say without doing an eye exam. If you haven't done this already, you can always supplement your current treatments with preservative-free artificial tears. If that does not work, I would ask your doctor if you would benefit from medicated treatments.
I hope you find some relief 🙏
thank you very much Dr Lee!
My Son is in his 20s and has it really bad
Iv been suffering with dry eyes inflamed eyes and been given 3 months steroid eye drops but it’s getting worse I can bearly see
So important to spread the word about Ocular Rosacea, great video! :)
Thanks for watching Dr. D! Agreed - it's such an underrated disorder and underdiagnosed cause of dry eye symptoms and irritation.
I have Ocular rosacea and it took about 4 years to get that diagnosis. I have very dry sensitive eyes and was put on Xiidra on my first appt. That was an unhappy journey, thinking it was helping because I got a smidge better, but my eyes were always hurting, vision off, headaches, red eyes. Finally got off xiidra a month ago with the help of Eyesuvis which is an amazing short-term flare up steroid, and I am on number 5 of my IPL treatments. I see an Ophthalmologist (who knew immediately by looking that is what I had) that does IPL dry eye and if actually goes over my lids and it has been the BEST thing. My eyes are so much better with very little swelling on my lid margin. It is a shame it is not covered by Ins as it is expensive. I will probably have to do this for ever hopefully only a couple of times a year after this initial course. Of course, like you mentioned you are told to apply heat heat sometimes 2x a day, I did this for 3 years and my lids were always so red, and I believe all that heat has damaged the delicate skin around my eyes making me look older. The heat never made the oil come out any better, every appt it was the same, toothpaste and not coming out enough etc etc. I do the IPL and now there is oil coming out. I do not think heat is the best for Ocular rosacea and have almost stopped doing it. Hope this can help someone. PS I did not know I had it on my face as I had infrequent flushing but once in a while when i got hot my cheeks and nose would get red and now, I know it is rosacea. I can wear a bit of makeup now ))))
Thanks for sharing your experience! Ocular rosacea is severely underdiagnosed and unfortunately requires a different treatment algorithm than other types of dry eye. I'm so glad you were properly diagnosed and able to get relief with IPL and topical steroids ❤
I want to get ipl so bad but I can't find a specialist in my area. My eyes are miserable. I've already tried plugs restasis and steroids. I think the heat is more harmful than helpful as well but every doctor I see keeps insisting I do it.
@@ktstone1443 I'm so sorry you are having a hard time finding a specialist in your area :( If your eyes feel worse with heat application, I would urge you to stop for a bit and see how your eyes feel. I can't speak for your eyes without seeing them, but if you have rosacea, heat is a common trigger. Also, sometimes doing less for a while can help your eyes reset so you can see what treatments are actually effective for you. I hope you get some relief soon ❤
@@MicheleLeeMD thank you so much 🙏 I would try anything at this point. Your videos are so helpful!
Same story exactly for me, going on almost 6 yrs now. I had my first IPL treatment today so I’m excited and hopeful. Very expensive, I’m paying $1800 out of pocket for 4 treatments. It’s crazy that insurance doesn’t cover this painful and very life disrupting condition. I agree also that warm compresses makes it worse.
My doctors wouldn't dx ocular rosacea at first. They just gave me the standard MGD diagnosis telling me to put warm compresses on my eyes several times a day plus dry eye drops. It was terrible. I realized that warm compresses were either too warm and exacerbated my rosacea or they weren't warm enough and did nothing for my dry eyes. After a little research I found out that ocular rosacea was a thing and made the connection with the redness of the lower lid and sometimes seeing papules and pustules in the lash line. I started using a manuka honey eyedrop that really helps with the inflammation of the lower lid. I take omega 3 oils every single day. I'm actually being treated for SIBO. Finally, I went to the dermatologist and somehow got them to give me a prescription for topical ivermectin cream which wipes out demodex. Another game changer. Unfortunately, IPL isn't available to me due to cost and my medical clinic doesn't offer it. Also thank you for the tip about steroid eyedrops not being a long term solution.
Hi Michele,
Dr Bill Marrocco here. I'm a retired Plastic Surgeon currently practicing Wellness Medicine. I was dx'd w/ ocular rosacea (OR) this summer. Responded well to doxy, but with intolerable GI consequences. Stopped doxy and started cyclosporine bid. I just started, so still too early to appreciate efficacy.
I'm planning a different approach. I now treat many patients with autoimmune disorders. Instead of suppressing the immune system, I use Low Dose Naltrexone (LDN) to reset it. Since OR has an autoimmune component, I'm going to give LDN a shot. If I enjoy improvement, I'll let you and my Ophtho know. If it does show promise, I think i'll opt for IPL and stay on LDN to prevent flares.
Great video, I love your delivery.......very informative, articulate, precise and concise. Thank you!
I'd love to hear how it goes. Thank you for sharing, and I look forward to your updates!
Hey there Dr, how is the Low Dose Naltrexone going? Just heard of this being used for gut motility ( I have SIBO issues , bloating and constipation, and ocular rosacea). Any update is appreciated, thanks!
So interesting! I know a few people whose long covid symptoms have improved so much with low dose naltrexone. What is the mechanism of action for low dose naltrexone helping disorders that affect the immune system?
Can I send you an email Doc? It’s urgent
My doctors can’t figure out what’s going on with my eyes, but recently someone through ocular rosacea out there as a possibility. Thank you for the helpful information!
Thanks for watching! I hope you are able to get some relief for your eyes ❤
I didn't know a person could get rosacea in the eye area? I was diagnosed with adult rosacea a few years back, its not as bad now, but I did have the tiny white bumps on the right side of my face, mostly, some eye flare ups with frequent styes, not as much now... at certain times of the year I will experience that dry eye deal for a week or two, then it goes away for months, but had no idea it was the rosacea? The dermatologist I saw prescribed a few different creams and the eye doctor, eye drops which didn't really work. I am glad its pretty much under control, but the flare ups are irritating as you can imagine. Thanks for this....
Thanks for sharing your rosacea journey! Agree that rosacea flares are very irritating, and I hope you are able to get a handle on your rosacea and dry eye ❤
I have diagnosed with Ocular rosacea for the past 4 months, it is not fun. All information for treatment and reduce flare ups is so useful. Thank you for sharing on this topic.
Thanks for watching! Hope you feel some relief soon ❤️
Manuka Honey eye drops and Oral Oil of Oregano
Thank you for your video. I was just put on doxycycline mono50mg capsule for 30 days twice a day. I get burning of the eye,tearing,itching of the eyelid. Every so often I wake with blurred vision sore eyes,and have anxiety that I may not be able to see clearly again. Vision returns and I am relieved. Not sure if this is related to ocular Rosacea or severe dry eye,it rarely happens.
Thank you for sharing your experience. It's hard to say whether your symptoms are due to rosacea or another cause of dry eye. WIthout knowing what your eye looks like, I can only advise lubricating with preservative-free tears when your vision is blurry or your eyes are irritated and seeing your eye doctor if you are really struggling. Hope you feel better soon ❤
I went to my ocular doctor and he is supposed to be very good and able, told me I “ have nothing “ , that I should be grateful , but I do have all of those symptoms
I didn't go yet but I am using over the counter antihistaminic eyedrops and it helps me with the symptoms.
Change doctors.
Hi, I have had rosacea since I was born and after a hysterectomy (which has made it full blown and constant) it seems to get more difficult to explain to friends and family why you don't feel good or why you can't join them for wine and spicy dinners. It's really a challenge to have a good "quality" of life. I thought I was just rare & I get depressed, so thanks for your video! ❤
Yeah, rosacea type 1, 2 and 4 here. This video was more helpful than some of the eye doctors I've been with. Thank you!
Thanks for your kind words ❤️
Thank you I have rosacea and I can’t believe I have it in my eyes now.. yay 🙁
I have Ocular Rosacea. I use lumify and dry eye preservative free drops. The best thing that has helped me is Manuka Honey eye drops 3x a day, Manuka Honey gel, Dry eye drops, lumify for any redness and a oral capsules or Oil of Oregano. This combo finally calmed down my eyes. It was getting so bad nothing was helping except lumify several times a day. I am a "responder" to steroid eye drops and my pressure went sky high so I couldnt take those. Now I can get away with lumify twice daily max sometime I do not need it at all. I was washing my eyes with a tea tree oil wash and doing warm compresses, the above combo mentioned was what ended up helping me.
Great protocol! I am also using the manuka honey eyedrops for my ocular rosacea. That and daily doses of omega 3 oils which has been a game changer. The Omega 3 oils make me feel like I don't have ocular rosacea.
@@puggirl415 how much Omega 3 do you take a day? I take 2000 but I still have symptoms. Do the Manuka honey eyedrops sting a lot? I often wonder why no Dr's mention them yet a lot of people seem to have success with them
I want to try honey makuka eye drop what brand should I get
Yes! I had SIBO and the rosacea went away when I changed my diet till the SIBO went away. I'm so glad you brought this subject up. Most people with rosacea do not know about this!!!❤
It just occurred to me that my eye issues might be related to my skin issues. Thank you for all of the information.
Thanks for your feedback and for watching!
@@MicheleLeeMD I have to find a dermatologist, first. But, do you know if there are any optometrist/opthalmologist who specialize in ocular rosaceae in the Denver area? Thank you in advance.
@@kbutcher I do not have any personal recommendations. If you look up "ophthalmologist denver dry eye" on google, a few practices pop up - the top hit looks very legitimate. Hope that kind of helps, and best of luck!
Yes, I’m pretty sure I have ocular rosacea! I have had IPL a number of times on my face and neck a number of times to control the redness. I have flares when my cheeks are bright red. In the last year, I have times when my eyes felt gritty and my eyelids were red and itchy. I was treated with a topical steroid on my eyelids for a month and then gradually tapered the dosage. I still have to use the steroid occasionally on my eyelids.
That sounds like rosacea! I'm glad you have found things that work for you to control your symptoms.
Dermatologist had put me on doxy- was on it just about a year- it did nothing for my eye lids but sure tore up mu stomach! So far Restatis, and any topicals they have tried is not working! So frustrating and so tired of the burning etc. Ice packs do help but only while they are on. Thx for the great video! I’ll be looking very closely at food/drink triggers!
I was recently diagnosed with ocular rosacea. I was already being treated for facial rosacea and my dermatologist recommended I see an ophthalmologist since I was having a lot of trouble with my eyes. I am newly into the treatment regimen (drops, ointment and an initial run of antibiotics), and I am seeing some improvement already. (It's only been about a month.) I am interested in IPL. I plan on asking my doctor about it.
Interesting video TY! I have eye dryness and double vision in left - say I need muscle surgery. Just a few days ago I developed odd inflammation on my nose and check. Derm doc today said it’s rosacea. My checks have been red since childhood. Had lots of sun - too much. Flush if embarrassed. I love heat in the form of hot tub and sauna!!! OMG do I need to stop? I own both!!! I live in SoCal so summer is coming. I am terrified at the moment listening to this video. I’m in my mid 70s. Thx if you can give input.
I was just diagnosed, looking back it’s been there a long time. I got use to the burning as it comes on gradually. I am working with a dermatologist for my skin and they are staring me on low dose doxy. I can’t believe my eye doctors did not catch it, do you have videos where you perform IPL?
I don't have an IPL video to share but there are some good videos out there on UA-cam about IPL for the eyes. Here are two videos I like:
ua-cam.com/video/v8TbYijQs2s/v-deo.html (Eye School with Dr. D)
ua-cam.com/video/4AvhT9fFcAk/v-deo.html (Doctor Eye Health)
Not everyone does IPL for ocular rosacea, this is usually done by an ophthalmologist or optometrist with a special ocular protocol. Hope this helps!
Very helpful video! I have been diagnosed with ocular rosacea and found that the hot compresses recommended for dry eye were definitely a trigger. My doctor hasn't mentioned IPL but it sounds promising. Thank-you for the information!
Glad it was helpful!
Thanks Doc.
Thanks for watching 🙏
I was recently diagnosed with dermatological rosacea. Just prior to diagnosis I had a stye and every morning, I wake up to crusty eyes. I don't have terribly red eyes or lids, but the constant crustiness, dry, gritty eyes is bothersome. I did not know ocular rosacea was a condition until I was reading about rosacea, but now I'm wondering if I have that as well.
Hello Dr found the presentation excellent,was diagnosed with Roscea some months ago male 52 yoa it started with the spots, I was aware of the ocular version which,in the printout the doctor gave me stated you could lose your sight with this condition.
I have had the gritty and sore eyes and now am wondering have i got it in my eyes,just finished long course of doxyceline and rosex cream,now terrified my sight will be effected or worse still lose it.
I know i cant go on the antibiotic long term but this is
making me very Anxious.
I have contacted the doctor again to see next steps.Again excellent presentation thank you.
I only recently got told I have this. Mine ended up causing me marginal keratitis. Currently going through my second flare up in 3 months.
That's rough. I'm so sorry you had cornea issues related to ocular rosacea. I hope things stabilize soon!
Thank you for this video. I have mild rosacea and recently my eyelids began swelling and itching. I just don't know if it is eye lid eczema or rosacea. How can I tell?
Thanks…I now get red on my cheek so now I can look at this at the issue.
Thank you for your video! I've always had redder cheeks than most all my life & suspected I had rosacea. It was over 18 months ago that it sort of exploded with more redness, some pustules & itchiness on my cheeks & around my eyes. The eye doctor diagnosed dry eye & prescribed Metronidazole cream to add to cleansed face twice a day. He also prescribed Restasis, but there is no way I can afford that! Funny, but the term occular rosacea was not used. So, can one have both dry eye & ocular rosacea at the same time? I'm not sure if heat is a trigger, but caffeine might be & for sure, sugar & chocolate are my biggest triggers! It's hard to cut down when you're a sugar/chocoholic! I do use preservative free natural tears eye drops, but I go through them pretty fast. Other than cleaning up my diet, I don't know what else to do.
That sounds like ocular and facial rosacea to me (but of course, I haven't examined you myself to confirm!). I would ask your eye doctor if steroid eye drops or IPL would be helpful for your dry eye symptoms, of which ocular rosacea is most likely contributing. Hope this helps, and best of luck!
So informational! Much appreciated!
What are the long term effects of untreated ocular rosacea?
Hi Lynn, most of the time ocular rosacea does not cause severe long term effects or cause permament loss of vision, though the symptoms are uncomfortable. Here are a couple things I have seen with chronic and severe ocular rosacea:
1) Atrophy and distortion of the eyelids (lid notches, misdirected eyelashes, loss of eyelashes)
2) Scarring and vessels on the cornea (the clear avascular layer in front of the eye)
Hope this helps and thanks for your comments!
@@MicheleLeeMD yes, I have had problems described in #1. I am surprised that no one caught it earlier. I am on Oracea now. It’s been about a week, my eyes no longer burn and the inflammation is really decreased. This med seems to be drawing out the plugged gland and I have 6 small styles all at once. Assuming these will clear. I admit I gradually got use to burning being somewhat unnoticeable it happen so gradually. Sad, it’s missed so often. I will look into IPL and may come to Scottsdale to do it. Thank you
Hi I am having a flare up of ocular rosacea. I am taking 4 kinds of eye drops/gel. I stopped wearing makeup but still using my eye cream. I am 63 yrs old and was using retinol for eyes every night which I stopped. I am trying to find concealers and anti aging skincare that won’t damage my eyes. Can you help me?
Liked and subscribed. I have rosacea, and my cornea doctor thinks I might have ocular rosacea. Just had the epithelial layer of the cornea removed followed by diamond burr polishing. It's taking longer to heal than anticipated, but I'm looking forward to having a healed eye!
I have EBMD, dry eye, meibomian gland dysfunction, resulting in recurrent corneal erosions. Not fun. But getting it taken care of.
Thanks for sharing! I hope your eye heals quickly, and best of luck ❤
Definitely not fun... It sounds like you have quite a few surface issues and that must be so frustrating 😞
Are there any long-term or lasting effects of having ocular rosacea?
Hi Emily, usually not but if you have severe ocular rosacea for a long period of time, there can be alterations of the eyelid margin (lid notches, loss of eyelashes) and cornea scarring. Mosf ot the time, these changes are only visible under a microscope, but rarely this can affect vision or cause permanent problem to the eyes. Hope this helps!
Thanks for this video. How can one differentiate rosacea from acne?
It's really tricky. Rosacea typically affects adults more often and is mostly on the mid-face. If you aren't sure you might need to see a dermatologist since the papulopustular form of rosacea can mimic acne. Thanks for your comment!
@@MicheleLeeMD really appreciated for the reply. Many thanks
Where are the doctors that have the protocol for treating O.R.? I have a dx of it - have tried warm compresses - they cause a flare for me, steroid eye drops - didn't make much of a difference, refresh artificial tears and Cequa help some, Doxy helps some, I am still having a lot of trouble with my eyes - where are the most experienced IPL doctors?
Hi there, I would ask your eye doctor who does IPL for ocular rosacea in your area. She/he will probably know who the local IPL people are.
Thanks for sharing your ocular rosacea journey with us and I hope you are able to get some relief soon!
This video was so informative. I just went to my dermatologist and asked about dark circles and he said there was no cure. However after viewing this video I think it's related to my Rosacea. Have you any experience with cool compresses for the eyes?
Thanks for your feedback. Cool compresses can help to a degree in helping constrict some of the vessels. Sometimes too cold might be an irritant as well, so don't overdo it!
Hey Claudia, dark circles under eyes could also be lack of iron, kidney issues, fatigue. I have it too. Mine are more kidney related due to stress. And severe ocular rosacea. Take care.
What about ocular seb derm?
i have been taking doxycycline 100 for a few years and advised to stop / how do i know if i need to go back on it
Hi Cantherine, that is a great question. There is no correct answer.
When I see patients who responded well to doxycycline in the past with minimal side effects but are having a flare of rosacea, I would advise they go back. I try to do only a 3 month course at a time but I have a few patients who are on a lower dose for an indefinite time. The decision to continue doxycycline or to go back on it is completely dependent on your symptoms and your response to the medication.
Hope that helps, and thanks for your question 🙏
I’ve been using Fluorometholone for several years and it’s the only thing that helps but I’m concerned about long term effects.
That's a fair concern. Make sure you are discussing side effects like eye pressure and possible cataracts if taken long-term with your eye doctor. Hope that helps!
Can this cause burning on the inside of the conjunctiva that makes your eyelids swell and your lashes fall out???
Thanks for watching! Ocular rosacea can definitely cause burning as a symptom, and chronic inflammation of the eyelids can result in lash loss. Hope that helps!
I have it. I have had rosacea for over 15 years as a teenager and since having my daughter it has spread to my eyes and it’s on my face horribly as well along with acne like bumps
Thanks for sharing ❤ I hope you are able to get some relief with treatment!
I've been diagnosed with ocular rosacea but only have slightly inflammed water lines - is that inline with it? and should I really not be hot compressing?
Hi there, it might be rosacea. It is hard to know for sure unless there are lid margin telangiectasias and other classic findings on our slit-lamp examination (hard to see this level of detail without a microscope). If you sometimes get a pinkish rim on your water line, it could be ocular rosacea, but I would ask your eye doctor if you aren't sure.
Warm compresses are really dependent on the person. Some with rosacea who don't have heat as a trigger find relief with warm compresses since it does open up the oil glands and help stabilize your tear film, but many people with rosacea will flare as heat is a major trigger of rosacea in general. Without knowing your eyes or history, I would say that if you have found that warm compesses are helpful for your symptoms, I would continue them. But if you don't feel a difference or if it seems to make your eyes and eyelids irritated afterwards, I would stop or ask your eye doctor.
Where is the water line?
@@lynnlind297 It's on the eyelid margin - where the skin and the conjunctiva (the clear vascular layer that lines the white part of the eye and inner eyelids) meet.
Yes I have it. I have an appointment for IPL. Im worried about the cost bc I hear most ins cos don’t cover it 😢
Hi, (a) I get relief from itchiness by squeezing my eyes tight then opening them wide repetitively for a minute or so. Is that bad or good for ocular rosacea? (b) Is eye-bathing with weak salt water beneficial?
Hi there, closing your eyes can definitely help with dryness since it will give your eyes a chance to lubricate with your natural tears. I don't recommend bathing your eye with tap water since there are so many parasites and bacteria in the water, but you can use preservative-free tears (sterile salt water) to wash out your eyes. Hope this helps, and thanks for your comment! 🙏
@@MicheleLeeMD Thank you so much for your response.
@@stegibabajamashim4390 Of course, hope it was helpful. Thanks again for watching ❤
Does boiling water kill the bacteria and parasites in tap water. Thank you for your videos. They are very informative.
What about Blink, which does have a preservative but apparently it dissipates once the drop comes out of the bottle. Do you think this is one is OK for eye rosacea? Thanks ❤
I m losing all my eyelashes in 40 days, all started with topical ivermectin, please help
You did not mention SD ocular rosacea. Imy diagnosis changed very quickly frm blepharitis and rosacea and atopic dermatitis to SD of skin and SD ocular derm. Finding an MD to treat this is difficult. Seems to me dermatologists dont want to touch it and pass it off as demodex or worse act as if nothing else. After 3 years of searching i think i have found an opthamologist who is well educated and young who is helping me. He believes i have a systemic infection or fungal or an allergy that is worsening this. Until we get to the root of this i am on doxy for 3 months plus alternating Claratin and and Zyrtc every other week. What do you thing? Most frustrating thing i have ever been through.😢
I have had a swollen upper eyelid for three years only on right eyelid. I have been to dermatologists, opthalmologists most of whom have no answers beyond steroids and antibiotic, which I refuse to use. All articles I read on ocular rosacea say there is itching or pain or irritation. I have none of that, only the swelling which sometimes swells around and beneath the eyes (bags) and also swelling of cheekat only on that one side. I'm not sure it is ocular rosacea and not all the doctors agree on that either. This is so very frustrating. I am on one blood pressure med and this swelling happened about 3 months after that - could this be caused by a medication? Thanks for any info or guidance.
I have ocular rosacea but for now I treat it with local antihistaminic drops : is this bad or not good enough ? It helps to reduce the symptoms... (I had first tried antibiotic cream but didnt help). Also I read about local Metronidazole eyedrops... Could it be useful!?
What percentage of ocular rosacea is caused by Demodex mites? I have dry eye, ocular rosacea and Demodex Blephartis. I'm taking the 6-week twice a day Xdemvy eye drops, and by my 3rd week my headaches were gone, and my eyes are clearer and not as red, and I can open my eyes in the morning without help. It's my understanding that the smaller mites (D. Brevis) live in the Meibomian gland and clog it up so it can't make tears as it's supposed to. There has to be a reason for rosacea and from what I've read most people have an overpopulation of Demodex. Can you respond to this? FYI, I'm using tea tree oil, which seems to be the only thing that can kill the mites.
I was diagnosed with skin rosacea this week. But had large stye on lower lid which my ophthalmologist treated a month ago with tobradex and compresses. A month later i have one on upper lid. Should i ask for oral antibiotics? Since it seems to be recurrent
I got diagnosed with Ocular Rosacea after seeing 5 doctors. I am on my 4th IPL treatments. My eyes still feel miserable. I do the warm compresses a few times a day. I was told to do this but I am thinking maybe it makes it worse. Should I do cold compresses instead?
Don't use the hot compresses... I use over the counter antihistaminic eyedrops and it helps me.
My right upper eyelid gets red & sometimes swollen. My dermatologist prescribed tacromilus. It calms it down but will flare up again from time to time. Is this ocular rosacea or blepharitis ? Any better way to cure ?
It's hard to say - if your dermatologist prescribed tacrolimus do you have eczema/atopy? If so, this may not be rocacea but atopic keratoconjunctivitis which is part of the atopy spectrum. My advice is to see a dry eye/cornea specialist who can properly diagnose and treat you. Hope you get better!
Thanks Dr Lee.