Sore red eyes? It could be a skin problem
ONE morning Julia Garner woke with the feeling she had something in her eye. She inspected it in a mirror but couldn’t see anything that might be irritating it. But the feeling persisted. Then, a few days later, both eyes started to become bloodshot. ‘It felt as if a handful of gravel had been thrown into my eyes. They felt very sore and were incredibly red,’ says Julia, 74. ‘My eyes were also very watery. I stopped going out because I looked so awful.’
After a few weeks, Julia went to a specialist eye casualty unit. The consultant said it was just dry eyes and gave her some drops. These made no difference, and her eyes continued to cause her pain. She also noticed her cheeks occasionally became flushed.
‘It came and went — my cheeks would suddenly become very hot,’ she says. ‘My nine-year-old grandson once gave me a kiss on the cheek and said, “Grandma your cheeks are burning!” ’
After searching her symptoms on the internet, she came across the condition ocular rosacea, which causes painful, bloodshot eyes. I is related to the skin condition rosacea, which is characterised by inflamed, red skin, most often on the cheeks and nose.
It usually strikes in middle age and can be triggered by sun exposure, alcohol and the menopause. However, the condition can be hard to detect. Some people develop ocular rosacea without the characteristic red cheeks of skin rosacea. Others have no skin symptoms at all — simply red painful eyes.
One study from the University of California found that in up to 90 per cent of patients with ocular rosacea, the underlying skin condition was ‘subtle or inexistent’.
More and more people are going to their doctor with the condition, says Daniel Ezra, an oculoplastic surgeon — but it is still going undiagnosed in a number of patients.
Ocular rosacea can easily be mistaken for dry eye — a condition where the protective liquid layer across the front of the eye, called the tear film, can become defective.
If the ocular rosacea is not treated, it can lead to severe complications such as a perforated cornea and sometimes even loss of sight.
It is treated with steroid drops to reduce inflammation, as well as tetracycline antibiotics, given either as tablets or eye drops. These have an antiinflammatory effect and also kill off harmful bacteria. It requires lifelong treatment of daily antibiotics to keep the symptoms at bay and patients are also advised to use weekly hot compresses to melt the thick secretions that block the glands.
Julia Garner now takes daily antibiotics to make sure her symptoms are kept under control. ‘Two weeks ago I went to get my latest prescription from my GP,’ she says. ‘She asked me if ocular rosacea was in fashion, as she’s seen five cases in the last two weeks.’