Indexed with PubMed and Science Citation Index (E) 
Users online: 30 
     Home | Feedback | Login 
About Current Issue Archive Ahead of print Search Instructions Online Submission Subscribe What's New Contact  
  Navigate here 
   Next article
   Previous article 
   Table of Contents
 Resource links
   Similar in PUBMED
    Search Pubmed for
    Search in Google Scholar for
   Article in PDF (130 KB)
   Citation Manager
   Access Statistics
   Reader Comments
   Email Alert *
   Add to My List *
* Registration required (free)  

  In this article

 Article Access Statistics
    PDF Downloaded232    
    Comments [Add]    
    Cited by others 7    

Recommend this journal


Year : 2009  |  Volume : 75  |  Issue : 4  |  Page : 405-406

Correlation of the severity of cutaneous rosacea with ocular rosacea

Tehran University of Medical Sciences, Tehran, Iran

Date of Web Publication3-Jul-2009

Correspondence Address:
Maryam Akhyani
Razi Hospital, Tehran University of Medical Sciences, Vahdat-Eslami Square, Tehran 1199663911
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0378-6323.53146

Rights and Permissions

How to cite this article:
Keshtcar-Jafari A, Akhyani M, Ehsani AH, Ghiasi M, Lajevardi V, Baradran O, Toosi S. Correlation of the severity of cutaneous rosacea with ocular rosacea. Indian J Dermatol Venereol Leprol 2009;75:405-6

How to cite this URL:
Keshtcar-Jafari A, Akhyani M, Ehsani AH, Ghiasi M, Lajevardi V, Baradran O, Toosi S. Correlation of the severity of cutaneous rosacea with ocular rosacea. Indian J Dermatol Venereol Leprol [serial online] 2009 [cited 2020 Sep 24];75:405-6. Available from:


The National Rosacea Society's Committee identified four subtypes of rosacea: Erythemato-telangiectatic, papulopustular, phymatous and ocular. [1],[2] The diagnosis of ocular rosacea should be considered when the patient's eyes have one or more of the following signs and symptoms: Watery or bloodshot appearance, foreign body sensation, dryness, itching, light sensitivity, blurred vision, telangiectasia of the conjunctiva and lid margin or lid and periocular erythema.  Meibomian gland More Details dysfunction presenting as chalazion or chronic staphylococcal infection are common signs of rosacea-related ocular disease. Some patients may have decreased visual acuity caused by corneal complications (punctate keratitis, corneal infiltrates/ulcer or marginal keratitis). [2] Although the frequency of ocular involvement in patients with rosacea is reported to be somewhere between 3 and 58%, its exact prevalence is not known. [3] In approximately 20% of the patients, eye findings may precede skin changes, making the diagnosis more challenging for both the ophthalmologist and the dermatologist. [4] This study is performed to evaluate the ocular signs and symptoms of rosacea and their relationship with severity of cutaneous lesions.

Sixty-four adult facial rosacea patients (28 men and 36 women) with a mean age of 39.3 (range = 22-56) years attending our clinic from September 2004 to September 2005 were enrolled in this study using simple sequential sampling. A thorough medical history and physical examination including skin manifestations was undertaken and recorded for each patient.

We classified each major sign and symptom of rosacea into three groups: Mild, instant flushing, light red erythema, telangiectasia of up to 10 lines, less than 10 papules or pustules and 1-3 small nodules (plaques); moderate, flushing duration of less than 15 min, red erythema, 10-20 lines of telangiectasia, 10-20 papules or pustules and 4-10 nodules (plaques); severe, more than 15 min of flushing, purple red erythema, more than 20 lines of telangiectasia and more than 10 large inflammatory nodules (plaques).

After skin examination, we referred all the 64 patients to an ophthalmology clinic. The ophthalmologist had performed a thorough examination of the eyelids, conjunctiva and cornea via slit lamps. The fluorecein test was also carried out on all the patients.

The common ocular symptoms in rosacea were eye dryness (21.9%), eye strain (14.1%) and tearing (4.7%). Similarly, other studies have reported that the common symptoms were foreign body sensation, burning sensation and eye irritability accompanied by visible reddening of the conjunctivae [3] . It is thought that meibomian gland impaction leads to decreased lipid in the tear film, greater tear evaporation and subsequent irritability of the eyes. [1]

The common ocular signs were meibomian gland plugging (45.3%), blepharitis (23.4%), keratoconjunctivitis (14.1%) and chalazia (14.1%). None of our patients had the less common, but significant, abnormalities like scleritis, episcleritis, iritis, iridocyclitis, hypopyon, corneal thinning, corneal neovascularization, scarring and blindness. Previous studies have demonstrated that meibomian gland dysfunction, chronic conjunctivitis and recurrent chalazia are the common ocular signs in rosacea. [4],[5]

In our series, ocular involvement did not correlate with the severity of papular, pustular, nodular lesions and flushing but, surprisingly, we found a significant relationship between the severity of telangiectasia and ocular involvement. This finding was not in agreement with the previous studies claiming that the ophthalmologic complications of rosacea are completely independent of the severity of facial rosacea. [5] On the other hand, it seems that the significant relationship between the severity of telangiectasia and eye lesions in our study might be an incidental experience. We agree with the general assumption that skin and eye lesions in rosacea are separate al together.

  References Top

1.Tanzi EL, Weinberg JM. The ocular manifestations of rosacea. Cutis 2001;68:112-4.  Back to cited text no. 1  [PUBMED]  
2.Wilkin J, Dahl M, Detmar M, Drake L, Liang MH, Odom R, et al . Standard grading system for rosacea: Report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol 2004;50:907-12.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Gessert CE, Bamford JT. Measuring the severity of rosacea: A review. Int J Dermatol 2003;42:444-8.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Wilkin J, Dahl M, Detmar M, Drake L, Feinstein A, Odom R, et al . Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol 2002;46:584-7.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]
5.Michel JL, Cabibel F. Frequency, severity and treatment of ocular rosacea during cutaneous rosacea. Ann Dermatol Venereol 2003;130:20-4.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]

This article has been cited by
1 Morphological and Functional Evaluation of Meibomian Gland Dysfunction in Rosacea Patients
Anna Machalinska,Aleksandra Zakrzewska,Agnieszka Markowska,Krzysztof Safranow,Barbara Wiszniewska,Miroslaw Parafiniuk,Boguslaw Machalinski
Current Eye Research. 2015; : 1
[Pubmed] | [DOI]
2 Rosacea and rhinophyma
Yalçin Tüzün,Ronni Wolf,Zekayi Kutlubay,Özge Karakus,Burhan Engin
Clinics in Dermatology. 2014; 32(1): 35
[Pubmed] | [DOI]
3 Ophthalmic Rosacea: Case Report in a Child and Treatment Recommendations
Christiane Potz-Biedermann,Tarun Mehra,Christoph Deuter,Manfred Zierhut,Martin Schaller
Pediatric Dermatology. 2014; : n/a
[Pubmed] | [DOI]
4 Rosacea with severe ophthalmic involvement and blindness - a rare occurrence
Karthikeyan Subashini,Gnanaraj Pushpa,V Venugopal,Narasimhan Murali
International Journal of Dermatology. 2012; 51(10): 1271
[Pubmed] | [DOI]
5 Rosacea and its ocular manifestations
Melissa Oltz, James Check
Optometry - Journal of the American Optometric Association. 2011; 82(2): 92
[VIEW] | [DOI]
6 Clinical and laboratory study of ocular rosacea in northern Greece : Study of ocular rosacea in northern Greece
E Lazaridou, C Fotiadou, NG Ziakas, C Giannopoulou, Z Apalla, D Ioannides
Journal of the European Academy of Dermatology and Venereology. 2011; : no
[VIEW] | [DOI]
7 Rosacea fulminans in pregnancy with ocular perforation | [Rosacea fulminans in der Schwangerschaft mit okulärer Perforation]
Ayres De Morais Silva, F., Bonassi, M., Steiner, D., Ribeiro Da Cunha, T.V.
JDDG - Journal of the German Society of Dermatology. 2011; 9(7): 542-543


Print this article  Email this article
Previous article Next article


Online since 15th March '04
Published by Wolters Kluwer - Medknow