Ocular Rosacea: A Comprehensive Guide to Symptoms, Causes, Triggers, Diagnosis, and Treatment

Ocular rosacea is a chronic inflammatory condition that affects the eyes and eyelids, often associated with the skin condition known as rosacea. This complex and often misunderstood eye disorder can impact individuals of all ages, although it is more prevalent among adults with fair skin. If you are experiencing symptoms of ocular rosacea, it is important to schedule a comprehensive eye care exam with our experienced optometrist in Olympia for a comprehensive eye exam.

Ocular Rosacea: A Comprehensive Guide to Symptoms, Causes, Triggers, Diagnosis, and Treatment in Olympia

Key Symptoms of Ocular Rosacea You Need to Know

Being informed about the symptoms of ocular rosacea can help you identify if you or a loved one may be suffering from this condition and seek appropriate eye care treatment from an optometrist.

Dry eyes

Ocular rosacea patients often experience dry eyes due to decreased tear production or poor tear quality. This can result in a gritty, sandy sensation in the eyes, making them feel constantly uncomfortable. It may also cause increased sensitivity to light and wind, leading to additional discomfort in various environments.


Redness: Inflammation in the blood vessels of the eye and the eyelids may cause persistent redness in the eyes, making them appear bloodshot. The eyelids may also appear red and swollen, especially near the lash line.

Burning or stinging

The inflammation associated with ocular rosacea can lead to a burning or stinging sensation in the eyes. This sensation may be exacerbated by environmental factors, such as smoke or dust, or by prolonged screen time.

Watery eyes

As a protective response to irritation, the eyes may produce excessive tears, leading to watery eyes. This symptom can be particularly bothersome for individuals who wear contact lenses or work in environments with a lot of airborne particles.

Blurred vision

The inflammation and dryness associated with ocular rosacea may cause temporary blurred vision, especially after waking up in the morning or during prolonged periods of screen time.

Itchy eyes

Patients with ocular rosacea may experience itching in and around the eyes, which can be exacerbated by allergens, dust, or smoke. It is crucial to avoid rubbing the eyes, as this can worsen the inflammation and symptoms.

Eyelid problems

Ocular rosacea can cause the development of styes or chalazia, which are painful, swollen bumps on the eyelid. This can result in further redness, swelling, and discomfort, as well as potentially impacting vision if the bump becomes large enough.

Corneal complications

In some cases, ocular rosacea can lead to complications involving the cornea, the clear front part of the eye. This can include corneal ulcers or even corneal thinning, which can result in vision loss if left untreated.

Bloodshot appearance

Chronic inflammation can cause the blood vessels in the eyes to become more prominent, leading to a bloodshot appearance. This symptom can be particularly distressing for patients who feel self-conscious about their appearance.

Sensitivity to light

Ocular rosacea may cause increased sensitivity to light, making it difficult for patients to spend time in bright or sunny environments without experiencing discomfort.

If you experience any of the above symptoms, it is crucial to consult with our eye doctor, who can provide a comprehensive eye exam and recommend appropriate treatment options. Please call us at (360) 491-2121 to schedule an appointment.

American Family Vision Clinic

Behind the Redness: Uncovering the Root Causes of Ocular Rosacea

While the exact cause of ocular rosacea remains unknown, several factors have been linked to its development, as identified by eye care professionals and optometrists. Some of these factors include:


A strong genetic component is thought to play a role in the development of ocular rosacea. Individuals with a family history of rosacea, particularly those of Northern European or Celtic descent, are at a higher risk of developing the condition. Although genetics cannot be changed, being aware of your family history can help you be proactive in monitoring your eye health.

Immune system response

An overactive immune system may contribute to the development of ocular rosacea. Some studies suggest that certain immune system proteins, such as cathelicidin, may be present in higher amounts in individuals with rosacea, leading to inflammation and the manifestation of symptoms.

Demodex mites 

These microscopic mites are naturally present on human skin, but they are found in higher numbers in individuals with rosacea. It is theorized that an immune response to the mites or their waste products may cause inflammation, contributing to ocular rosacea symptoms.

H. pylori bacteria 

The presence of Helicobacter pylori bacteria in the digestive system has been linked to the development of rosacea, although the exact relationship is not yet fully understood. It is thought that the bacteria may cause increased production of a protein called gastrin, which could potentially contribute to the inflammation associated with ocular rosacea.

Vascular issues

Abnormalities in the blood vessels of the eye and eyelids may contribute to ocular rosacea. These abnormalities can include increased blood vessel dilation, which can cause redness, and the development of new, fragile blood vessels that are prone to inflammation.

Environmental factors

Certain environmental factors can exacerbate ocular rosacea symptoms or contribute to their development. These factors include exposure to sunlight, wind, extreme temperatures, and airborne irritants such as smoke, dust, or allergens.

Hormonal factors

Hormonal changes, particularly those related to menopause, can trigger or worsen ocular rosacea symptoms. Fluctuating hormone levels may cause increased blood flow to the skin, leading to inflammation and the appearance of redness.


Certain medications, such as corticosteroids or vasodilators, can contribute to the development or worsening of ocular rosacea symptoms. These medications may cause blood vessels to dilate or increase inflammation in the body.


Psychological stress has been linked to the onset or exacerbation of ocular rosacea symptoms. Stress can cause an inflammatory response in the body, leading to redness, swelling, and discomfort in the eyes.

If you believe you may be experiencing ocular rosacea or have concerns about your risk factors, it is crucial to consult with our optometrist, an eye care specialist, for a comprehensive eye exam and personalized advice. Early diagnosis and intervention are key to managing this chronic condition and preserving your eye health with the help of comprehensive eye care. To schedule an appointment, please call us at (360) 491-2121.

The Hidden Factors that Can Aggravate Your Ocular Rosacea

Certain factors can trigger or worsen symptoms of ocular rosacea. Being aware of these triggers can be crucial in maintaining your eye health and ensuring that you receive appropriate treatment when necessary. Following are the triggers of ocular rosacea:

Sun exposure

Prolonged exposure to ultraviolet (UV) radiation from the sun can trigger or worsen ocular rosacea symptoms. UV radiation can cause inflammation in the eyes and eyelids, leading to redness, swelling, and discomfort. It is essential to protect your eyes from excessive sun exposure by wearing sunglasses with UV protection, a wide-brimmed hat, or seeking shade when necessary.

Hot or cold temperatures

Extreme temperatures, whether hot or cold, can exacerbate ocular rosacea symptoms. Hot temperatures can cause blood vessels to dilate, increasing redness and inflammation, while cold temperatures can make the eyes more sensitive and prone to dryness. It is crucial to protect your eyes from harsh weather conditions by wearing appropriate eyewear and maintaining a comfortable indoor environment.


Exposure to strong wind can irritate the eyes and trigger ocular rosacea symptoms. Wind can cause dryness, redness, and discomfort by disrupting the tear film that protects the eye surface. To minimize the impact of wind, wear wraparound sunglasses or protective eyewear when outdoors in windy conditions.


Emotional and physical stress can trigger or worsen ocular rosacea symptoms. Stress can lead to an inflammatory response in the body, resulting in increased redness, swelling, and discomfort in the eyes. It is essential to manage stress through relaxation techniques, exercise, and maintaining a healthy work-life balance.

Alcohol consumption

Alcohol can cause blood vessels to dilate, increasing redness and inflammation in the eyes. Excessive alcohol consumption may trigger or exacerbate ocular rosacea symptoms. Limiting alcohol intake or avoiding it altogether may help minimize the impact of this trigger.

Spicy foods

Consuming spicy foods can cause blood vessels to dilate, leading to redness and inflammation. For individuals with ocular rosacea, spicy foods may trigger or worsen symptoms. It is recommended to monitor your diet and reduce the intake of spicy foods if they contribute to your symptoms.


Caffeine can cause blood vessels to constrict, which may exacerbate dry eye symptoms associated with ocular rosacea. Reducing or eliminating caffeine consumption may help alleviate some ocular rosacea symptoms.

Environmental irritants

Exposure to environmental irritants, such as smoke, dust, or allergens, can trigger ocular rosacea symptoms by causing inflammation and irritation in the eyes. Minimizing exposure to these irritants by using air purifiers, avoiding smoking areas, and maintaining a clean living environment can help reduce the impact of this trigger.

The Hidden Factors that Can Aggravate Your Ocular Rosacea
The Hidden Factors that Can Aggravate Your Ocular Rosacea

The Hidden Factors that Can Aggravate Your Ocular Rosacea

Prompt diagnosis is vital for effectively managing ocular rosacea and maintaining good eye health. The following steps and considerations play a crucial role in diagnosing ocular rosacea:

Comprehensive eye examination

A thorough eye examination is the first step in diagnosing ocular rosacea. During this exam, our optometrist at the optometry clinic will assess your eye health, evaluate your symptoms, and look for signs of inflammation and other indicators of ocular rosacea.This examination may include tests for visual acuity, eye pressure, and a detailed evaluation of the eye's structures using specialized equipment.

Patient history 

Obtaining a detailed patient history is essential in the diagnosis process. Our optometrist will ask about your symptoms, their duration and severity, any previous eye issues, your family history of rosacea or other eye conditions, and any medications you are taking. This information will help us determine if ocular rosacea may be the cause of your symptoms and identify any potential contributing factors.

Evaluation of eyelids and eyelashes

Ocular rosacea often affects the eyelids and eyelashes, leading to inflammation, redness, and the formation of styes or chalazia. We will closely examine your eyelids and eyelashes for signs of these issues and assess the overall health of the surrounding skin.

Assessment of tear production and quality

Ocular rosacea can cause dry eyes due to decreased tear production or poor tear quality. We may perform a Schirmer's test or a tear film break-up time test to measure your tear production and assess the quality of your tears.

Slit-lamp examination

A slit-lamp examination allows us to closely examine the front part of your eye, including the cornea, conjunctiva, and eyelids. This examination can help identify signs of inflammation, blood vessel abnormalities, and other indicators of ocular rosacea.

Corneal evaluation 

In some cases, ocular rosacea can cause complications involving the cornea, such as corneal ulcers or thinning. We will assess the health of your cornea during the eye examination to identify any issues that may require further attention or treatment.

Ruling out other conditions  

It is important to rule out other eye conditions that may present with similar symptoms, such as conjunctivitis, blepharitis, or allergies. We will consider your symptoms, examination findings, and patient history to differentiate between ocular rosacea and other potential causes.

Collaboration with other healthcare professionals

In some cases, we may collaborate with other healthcare professionals, such as dermatologists or rheumatologists, to further assess your condition or rule out other potential causes. This collaborative approach, along with our eye care services, ensures a comprehensive evaluation and accurate diagnosis.

The Hidden Factors that Can Aggravate Your Ocular Rosacea

Discover the Best Eye Care Treatment Options for Ocular Rosacea Relief from Our Optometrist

We will elaborate on various treatment options for ocular rosacea, which can help you better understand how to manage your condition and maintain optimal eye care and health.

Artificial tears

Dry eyes are a common symptom of ocular rosacea. Using over-the-counter artificial tears can help relieve dryness, discomfort, and provide additional lubrication for your eyes. Be sure to consult our eye care professional for recommendations on which products may be best suited for your needs.

Lid hygiene

Maintaining good eye hygiene, particularly eyelid hygiene is crucial in managing ocular rosacea. Gently cleaning your eyelids with a warm, moist cloth or using a commercially available eyelid cleanser can help reduce inflammation, remove debris, and control bacteria on the eyelid margin.

Warm compresses & In-Office Heating

Applying warm compresses or having a more thorough treatment done in our office, can help alleviate symptoms of ocular rosacea by increasing blood flow, reducing inflammation, and loosening debris around the eyelashes. 

Prescription medications

Depending on the severity of your symptoms, we may prescribe medications to help manage ocular rosacea. These may include topical antibiotics, such as erythromycin or metronidazole, or oral medications, such as doxycycline or azithromycin. These medications can help reduce inflammation and control bacterial overgrowth.

Steroid eye drops or ointments

In some cases, short-term use of steroid eye drops or ointments may be recommended to reduce inflammation and alleviate symptoms. However, these medications should be used with caution and under the supervision of our optometrist, as they can have potential side effects, including increased intraocular pressure and cataract formation.

Punctal plugs

If dry eye symptoms are severe and not relieved by artificial tears or other treatments, we may recommend punctal plugs. These tiny devices are inserted into the tear ducts to help retain moisture on the eye surface by blocking tear drainage.

Omega-3 fatty acids

Some studies have suggested that omega-3 fatty acids, found in fish oil and flaxseed oil, may help reduce inflammation associated with ocular rosacea. Consult with our optometrist about incorporating omega-3 supplements into your treatment plan.

Advanced treatments

There are a wide range of advanced treatments targeting the dry eye and poor tear quality. Treatments may include amniotic membranes, scleral contact lenses, and goggles. 

Managing triggers

Identifying and managing triggers that exacerbate ocular rosacea symptoms can help reduce the frequency and severity of flare-ups. Common triggers include sun exposure, extreme temperatures, wind, stress, alcohol consumption, spicy foods, caffeine, and environmental irritants. Avoiding or minimizing exposure to these triggers can help improve your ocular health.

Collaboration with other healthcare professionals

In some cases, we may collaborate with other healthcare professionals, such as dermatologists or rheumatologists, to develop a comprehensive treatment plan for your ocular rosacea. This collaborative approach ensures that your treatment is tailored to your specific needs and addresses any underlying issues.

Don't hesitate to reach out to discuss treatment options or to seek additional guidance on managing your ocular rosacea.

Common Questions

Treatment for ocular rosacea includes a combination of medications, self-care measures, and lifestyle changes. Artificial tears can alleviate dryness, while lid hygiene and warm compresses can reduce inflammation. Prescription medications such as topical or oral antibiotics may be used to control inflammation and bacterial overgrowth. Managing triggers, incorporating omega-3 supplements, and collaborating with healthcare professionals are other strategies for effective treatment. We are fortunate to have developed strong referral relationships and co-management relationships with many healthcare providers from Olympia, Lakewood, Tacoma, and Lacey.
Ocular rosacea can become serious if left untreated, potentially leading to complications such as corneal ulcers, infections, or vision loss. Early diagnosis and treatment are crucial to prevent these complications and preserve eye health.
Symptoms of ocular rosacea include redness, itching, burning, watering, sensitivity to light, and blurry vision. If you suspect you have ocular rosacea, consult our eye care professional for a comprehensive eye examination and accurate diagnosis.
At-home treatments for ocular rosacea include using artificial tears, maintaining eyelid hygiene, applying warm compresses, managing triggers, and incorporating omega-3 fatty acid supplements. However, it is crucial to consult with an eye care professional to develop an appropriate treatment plan.
Common triggers of ocular rosacea include sun exposure, extreme temperatures, wind, stress, alcohol consumption, spicy foods, caffeine, and environmental irritants. Identifying and managing these triggers can help reduce flare-ups and improve ocular health.
Yes, untreated ocular rosacea can cause damage to the eyes, leading to complications such as corneal ulcers, infections, and vision loss.
Ocular rosacea stages can include mild symptoms like redness, irritation, and dryness, progressing to moderate stages with increased inflammation, eyelid abnormalities, and vision disturbances. In severe cases, complications like corneal ulcers or scarring may occur, potentially leading to vision loss.
Natural treatment options for ocular rosacea include using artificial tears, applying warm compresses, practicing eyelid hygiene, managing triggers, and incorporating omega-3 fatty acid supplements. However, it is essential to consult with an eye care professional to develop a comprehensive treatment plan tailored to individual needs.
While the exact cause of ocular rosacea remains unclear, it is believed to involve a combination of genetic, immune system, and environmental factors. Some researchers speculate that an autoimmune component may be involved, but further research is needed to confirm this.
Dr. Zurcher cartoon

Regain Clarity and Comfort: Expert Eye Care for Ocular Rosacea with Our Optometrist in Olympia and Beyond

Don't let ocular rosacea compromise your vision and quality of life. Take the first step towards better eye care by calling our optometrist in Olympia at (360) 491-2121 today. Let our experienced team help you navigate this condition with personalized care and effective treatment options.

We are honored to serve patients with ocular conditions like ocular rosacea from across Washington. Our clinic is a renowned provider of comprehensive optometry and eye care services, welcoming patients from Olympia, Lakewood, Tacoma, and Lacey.


Such a nice optician. My grandson is only 4 and needs glasses. We were so sad, but he explained the issues, and we will follow up as he suggested.

Anna P.

I had such a good experience with the clinic. Very friendly staff and doctor, did not have to wait for long to be called, and was treated respectfully. Thanks, American Family.

June S.

Dr. Zurcher has gone above and beyond what any other eye doctor has ever done to figure out what is going on with my eyes. Very happy with American Family Vision.

Christine R.

Family Vision Clinic changed our lives! My daughter was frequently car sick, and she was getting headaches every day, often painful enough that they brought her to tears. We saw a string of doctors and therapists, but we made no progress. Finally, we found Dr. Levi Zurcher and his eye therapist Rain. After ten weeks of eye therapy my daughter no longer gets headaches, and she no longer gets car sick. Daily tears are a thing of the past. I really can’t say enough about this clinic. It was fascinating to watch Dr. Zurcher work. For the first time, someone who knew what they were doing was intently studying my daughter, really trying to figure out all of her eye issues, and his therapist Rain is one of the most patient and lovely people that I’ve ever had the good fortune to meet. We’re finished with eye therapy—yay!—and I have switched to American Family Vision Clinic for all of my family’s other eye health needs.

Lars Wulff

Very professional, yet kind and helpful. They do what they can to make the appointment comfortable. I was running a bit late, I made sure ti call. They were able to switch me with a patient who was already there, they treated me with respect, and helped my son have confidence by getting him the eye care he needed that day. Thank you so much! Would recommend to anyone. It's a blessing that they care enough to work with people who have all different types of insurance from work to state coverage.

Justin E.

The staff is friendly. The Doc is very knowledgeable. The office is family friendly and everyone is so patient with the little ones.

Amy Fagerness
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