Association between skin findings and ocular signs in rosacea

Purpose: To report the most frequent signs in ocular rosacea and evaluate their association with skin findings. Materials and Methods: 51 patients with rosacea that had been previously diagnosed by a trained dermatologist were evaluated by an ocular surface specialist. A complete ophthalmological examination was performed. Results: In our study, the prevalence of ocular signs in patients with rosacea was 74.5%. The average age of presentation was 50 years and women were more affected than men. The most common findings were lid margin erythema, Meibomian gland dysfunction and blepharitis. 15 patients had decreased visual acuity due to complications related to rosacea such as leukoma and corneal neovascularization. Interestingly, patients that had the lowest visual acuity presented with dermatological signs of papules and pustules (p=0.001018); and rhinophyma (p= 0.02348). 2 patients that showed subepithelial fibrosis and fornix foreshortening were diagnosed as ocular cicatricial pemphigoid by immunohistopathological analysis of conjunctival specimens. Conclusions: Ocular compromise in rosacea is common. Our study shows that there might be a relation between the severity of ocular compromise and certain subtypes of cutaneous disease. Rosacea and ocular cicatricial pemphigoid may coexist. In cases that present with conjunctival fibrotic changes, a diagnostic biopsy is mandatory.