Q: After noticing my cheeks were getting redder, I saw a dermatologist who diagnosed rosacea and put me on a medication. I am looking better, but believe my eyes are drier than ever. Is my medication causing this?
A: Your skin condition, rosacea, is very common, and yet is very under-diagnosed. I am glad you saw a dermatologist for this, as they are the very best in diagnosing and treating this sort of condition. Unfortunately, most patients with rosacea do not realize that certain eye effects are commonly associated with it.
In our practice, I would say most patients with rosacea have some degree of eye inflammation also. These are commonly problems with the oil glands of our eyelids. People seldom know, but we have about 40 tiny oil-producing glands in each eyelid. They are designed to secrete a little bit of very thin oil into our tear film with every blink. This oil is critical to holding our tear film intact from one blink to the next. Without the normal oils, our tear film evaporates too quickly, leaving dry spots on our eye surface. Those dry area create some fuzziness in our vision and some drying effect, until we blink or rub our eyes.
So, to finally answer your question, your eye symptoms are very normal in rosacea, and are not caused by your medication. In fact, the most common medications for rosacea are also prescribed in our office for the eyelid problems. As your dermatologist likely told you, those medications can increase your tendency to sunburn in direct sunlight.
We now have very good diagnostic techniques to see if your eyelid oil glands are functioning normally, and excellent treatments to restore normal function. This is critical for you to know, as we now know that your condition can cause your oil glands to become completely plugged and die. This progressive damage can result in very severe dry disease in years to come, so that intervention and active treatment is essential. We use in-office procedures to painlessly restore oil gland function, and usually prescribe some at-home treatments as well. These may include specialized fish oil supplements in your diet, topical eye drops to restore tear film oils, and eyelid moist heat compresses. Finally, most patients with this eyelid oil gland condition will need periodic eyelid treatments to prevent further damage — a little like getting your teeth cleaned every six months.
So, you need a thorough dry eye evaluation to determine the status of your eyelid health. Treatments vary with the severity of your condition and several factors. Your eye doctor, if they specialize in dry eye disease, can take steps to keep your eyes comfortable and clear all you life.
DR. THOMAS STOUT, OD, FAAO is an eye physician in private practice at Morgantown Eye Associates. Info: MorgantownEye.com.