Blepharitis - I need some advice

[Ontarian]

Hello.
This year I was diagnosed with rosacea by my regular dermatologist. Another derm. (to whom I went for second opinion - a very old dr., by the way) said he couldn't see rosacea, only seborrheic dermatitis (which I had been diagnosed with in 2001). I was left not knowing what I really have (although, my gut feeling says both rosacea and seb. derm.)...

A few days ago I went to an optometrist. I told her about my chronically burning eye. She said I had blepharitis due to rosacea (apparently, my meibomian glands get clogged). My eyelid edges are red, my eye is burning, and I see some blood veins on the inside of my lower eyelid and on the outside of my upper eyelid.

I have started using warm compressants and lid-scrubs, which seem to only make things worse.

Has anyone here treated this condition successfully? The thought of having this for the rest of my life is extremely depressing, I don't know how to handle such burning/pain. Has anyone here gone into blepharitis remission? How long do blepharitis remissions last? I hope they are long...Otherwise, I'll go nuts.

Also, how do I really know whether my blepharitis is caused by rosacea or seborrheic dermatitis?

Thanks in advance.

[newattitude]

hello there. there is a lot of info on this if you do some searches.no more red cheeks has had great success with occcular rosacea by following an alkaline diet.look up her posts or drop her a line. i am sure she would help you. many others have struggled and overcome. best of luck to you and dont despair...................lin

[Canada Dude]

Doxycycline or low dose accutane (10mg's a day) is great for the eyes. Lots of refresh tears, as much as you feel needed. Perhaps using a low dose steroid drop in short courses, you can get this from your eye doc, it worked well for my eyes. I don't have any issues with my eyes now by using these things that helped me.

[Ontarian]

Thanks for your replies, guys.

Canada Dude,
I have noticed lots of broken blood vessels on my lower eyelids (on the inside part). They almost go all the way up to the eyelid margin. I don't remember seeing those ugly broken red veins before. Are those broken blood vessels inside the lower eyelids part of blepharitis / meibomian gland dysfunction /ocular rosacea or are they a normal occurence?

See, I do not flush insanely...I've heard that ocular rosacea is mostly present in people who flush a lot. I am totally confused, as I still don't have very visible blood vessels on my facial skin. Why would they be on my eyelids? Could this be unrelated to rosacea?

Canada dude, where in Canada are you? I have such a horrible treatment by doctors here in Ottawa. They all dismiss me very quickly, as if I am lying about my symptoms...I went to a dermatologist yesterday and he said he didn't treat the eyes (even though my family dr. said that he should be treating them) and he said that he had never seen ocular rosacea in people who did not flush a lot. But, I think I read that this was not the case - ocular symptoms can appear before facial skin symptoms, right?

My family dr. won't send me to an eye dr. I don't know what to do and whom to ask for help... :(

[Froggirl]

See, I do not flush insanely...I've heard that ocular rosacea is mostly present in people who flush a lot. I am totally confused, as I still don't have very visible blood vessels on my facial skin. Why would they be on my eyelids? Could this be unrelated to rosacea?

My eye problems are from seb derm rather than rosacea and i have these on my eyelids too. I think i just never noticed before because i now notice that other people have these too.
Refresh preservative free eyedrops made a huge differnece when my eyes were bad. The seb derm blocks the eyes tear ducts and can mean that the tear film is not spread over the eye surface resulting in painful dry red eyes. There are also the cream ones for night that help stop the eyes drying out in the night. This and washing the eyelids with lidcare really helped me.

After a couiple months of by eyes being awful they just got better and are now such a mild issue that i forget about it most days. Not sure if this was due to anything i did. I did get my seb derm on my face under control and also satrted daily fish oil and flaxseed around that time. My gut feeling though is that it just gor better.

I did try dorxy for two months and it had no impact. It made me feel better though because i was worried that maybe it was occular rosacea. Maybe your regular doctor will let you try this if he won't refer you on? Would be good to see how the rest of your facial skin reacts to the Dorxy too. If it clears the redness right up that it may indicate rosacea rather than seb derm. Part of the reason i am sure that, aside from flushing, my issue is seb derm rather than rosacea is because i have tried all rosacea topicals and antibotics with no result, whereas topicals for seb derm have worked.

Hang in there, it can get better!

[Canada Dude]

I live in Winnipeg. You have to see a "opthamologist" not a optomotrist, any of them can treat your eyes. The fact is that when you treat the eyes, and treat teh facial flushing all, or most sysmtoms of ocular rosacea will go away.

My eyes were so bad I could not even walk in a shopping mall cause of the light and indoor air in thoses places. Now my eyes are normal, thoguh they can still look a little red from time to time.

[Ontarian]

Froggirl and Canada Dude,
thanks for your replies again. You gave me a bit of hope that I will be able to get things under control. It's encouraging to read that both of you managed to get your eye symptoms under control after some really bad flare-ups.
I tend to stress and worry about my symptoms every day 24/7 and it is starting to drive me crazy. Maybe that has an impact on my overall well-being. I will try to get an appointment with an opthamologist soon and see what happens.

Froggirl,
I try to convince myself that all my problems come from seborrheic dermatitis rather than rosacea, but one minute I think - "definitely rosacea", and the next I comfort myself "it could be seborrheic dermatitis"...But, see, my eyes are not flakey at all. I have posterior dermatitis and my optometrist said that it was caused by the malfunction of meibomian glands. All Internet sources seem to say that the dysfunction of meibomian glands is caused by rosacea rather than seborrheic dermatitis. On the other hand, my eyes were better in the summer, which might mean that seborrheic dermatitis is the cause, as it tends to flare in the cold months rather than summer...Ugh, so complicated...

Thanks again for your help and support, guys.

[Ontarian]

Hello again.
I am sorry if I am really annoying with my questions, I am just trying to understand some things.

Here’s my new question:
Everyone has those little red lines in their eyes – some people have more, some less, also depending on persons’ tiredness, lack of sleep, etc., etc. However, I have recently noticed some weird red lines in the white part of my eyes. These don’t look like ordinary red lines – these are redder, more defined, and longer, and they go almost all the way to my pupils. While “normal” red lines appear, disappear, and change, these more pronounced lines are always there. I’ve noticed them a few months ago and they are still here – unchanged.

My question is: Are these new red lines in the white part of my eyes somehow related to blepharitis/ rosacea/ meibomian gland dysfunction? Are they gonna stay there forever or do they eventually disappear?

Thanks for your patience.

I used to be on the board a lot, but just check in every few weeks now. I haven't had rosacea symptoms since last Christmas when I upped my estrogen dose, except every now and then the red, scaley, itchy eyelid problem starts to return when my next dose is due. I'm menopausal and use estradiol gel twice a day. Within 15-30 minutes of using the gel (which I put on my legs), the ocular symptoms disappear completely. It is truly amazing to put my finger on my eyelid and feel how it has become smooth within so short a time.

Before I increased my estrogen dose, my symptoms also included constantly swollen, cracked upper and lower lids, burning, feeling of grit in the eye, and dryness of the eyeballs. It was miserable and I tried clarithromycin, doxycycline and low-dose Accutane. None of that worked. I did get some relief from burning and "grit in the eye" feeling from Patanol eye drops.

The eyelid symptoms first appeared in my late 30's, and I thought at the time it was an allergic reaction. I put cortisone on it and it always went away in a day or two. I now realize that it was a symptom of lowered estrogen and disappeared because my estrogen level had returned to normal, not because of a one day use of cortisone. I did not have any flushing or other signs of rosacea that I was aware of back then. I do remember standing in a dept. store dressing room and looking in the mirror, wondering why the red lines in my eyes looked so prominent. I don't have those prominent red lines today.

Many women get rosacea only in perimenopause or afterward, but it is apparently unknown by medical science that estrogen can eliminate rosacea (in at least one woman--me!) Many women will say that estrogen didn't cure their rosacea. I was also taking estrogen when I had my worst rosacea symptoms, but I just wasn't taking enough. Apparently, the skin and eyes need the most estrogen and/or the steadiest supply of estrogen. I use only bioidentical hormones and I believe the skin form is better than the oral for rosacea, but "everybody's different". Of course, if you are younger than late 30's or male, this won't help you!

[irishgenes]

Sorry, I wasn't logged in when I posted the above.

[Ontarian]

Hi, Irishgenes.

Thanks for your info. However, I am male and I just turned 30.
Since you mentioned hormones, however, I wonder if any of this can be caused by Propecia (finasteride) that I have been taking for the last 7 years....Hmmmm...

[irishgenes]

I do think that hormones play a role in rosacea for men, too, as men also get rosacea more commonly in mid-life when testosterone decreases. (I would guess that most of the men on this forum are young, but this is a self-selected internet-using group.) I Googled "side effects Propecia" and found that some men say they have suffered side effects that sound like they could be due to lowered testosterone. (I won't go into the embarrassing details!)

Although Propecia is supposed to be just a DHT blocker, it is still a man-made chemical foreign to the body, and sometimes drug side effects are discovered years later. Here is a forum where they discuss Propecia side effects. Don't know what they say, as I didn't join!
http://health.groups.yahoo.com/group/finasteride_side_effects/

I guess you could try quitting the Propecia for a few months to see if your eyelids get better, but then you'd worry about your hair loss.