Rosacea affects an estimated 14 million Americans. Many people with rosacea do not realize that the skin condition associated with redness on the cheeks and nose can also affect the eyes. In fact, about half of people with rosacea also have a form of ocular rosacea known as meibomian gland dysfunction or blepharitis.
Each eyelid contains a row of meibomian glands. They secrete the oil layer of tears. When a person has blepharitis, either as part of rosacea or due to other factors such as aging, the secretions from the meibomian glands become thick and viscous. This prevents the tear film from properly moistening the eye. While blepharitis does not affect the eyesight, it can lead to dryness, blurred vision, redness and pain. Left untreated, it can also lead to inflammation of the cornea.
Treatments for meibomian gland dysfunction:
- Ophthalmologists may prescribe oral antibiotics if a bacterial infection is the cause of blepharitis. Other treatments include eye lid scrubs, warm compresses and topical steroids.
- Intense pulsed light (IPL) therapy, used by dermatologists to treat rosacea, is now used to stimulate the meibomian glands. Multiple treatments are usually required. IPL is not fully covered by insurance.
- Some ophthalmologists also perform a 15-minute surgical procedure called intraductal meibomian gland probing, which involves unblocking the glands with a fine probe. A small study conducted in 2010 found that 80 percent of patients who underwent this procedure experienced 11 months of relief from dry eye after a single treatment.
- High doses of omega-3 fatty acids, such as fish oil, have been found to significantly improve meibomian gland dysfunction.
- In 2010, the Food and Drug Administration cleared a device to express blocked meibomian glands. This device, called LipiFlow, applies heat and pressure to the eyelids—similar to the action of blinking and warm compresses. It is not covered by insurance, but for patients who just can’t find relief, the $1,500 price tag might be worth it.