Ocular rosacea, often accompanied by meibomian gland dysfunction (MGD), can present with subtle symptoms, such as dry, gritty eyes and redness at the lid margin, rather than the typical signs like red or bloodshot eyes, according to Dr. Julie C. Harper. MGD affects a significant portion of rosacea patients, ranging from 8% to 85%. Common symptoms include foreign-body sensation, burning, blurred vision, and excessive tearing.
Treatment for MGD includes warm compresses, eyelid massage, artificial tears, and medications like topical azithromycin and oral doxycycline. Harper recommends avoiding topical steroid drops due to the risk of glaucoma and suggests alternatives like no-tears shampoos and topical ivermectin 1%, which has shown effectiveness in managing both skin and ocular symptoms. Omega-3 fatty acids, particularly in flaxseed or fish oil form, may also provide relief for persistent symptoms.
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