Rosacea: An Introduction

Lids and Conjunctiva in Ocular Rosacea

The commonest clinical manifestation is blepharoconjuncivitis.

In such cases, the lid margin demonstrates capping and inspissation of the meibomian gland orifices along with a characteristic filigree telangiectasis of the lid margin.

Diffuse "lacy" hyperemia of the lid margin in rosacea blepharitis.

A history of recurrent hordeolum and chalazion is common.

Excessive meibomian secretions may result in foamy tears.

As many as 55% of patients undergoing chalazion surgery have been reported in one study to have signs of cutaneous rosacea.

This finding emphasizes the strong association between rosacea and meibomian gland dysfunction.

In addition, one may see the findings of staphylococcal blepharoconjunctivitis present concomitantly at the lid margin.

Conjunctival findings may vary.

Commonly, there is diffuse hyperemia with marked congestion of the bulbar conjunctival vessels in the interpalpebral space.

Characteristic interpalpebral bulbar conjunctival injection in rosacea blepharoconjunctivitis in the patient seen in the above photo.

There is often a follicular reaction in the inferior fornix as well as a fine, diffuse papillary hypertrophy of the tarsal conjunctiva.

Although commonly bilateral, the findings in rosacea can be asymmetrical.

Lemp has reported the association of keratoconjunctivitis sicca in up to 40% of patients.

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