Ocular Rosacea
A 58-year-old man presented with recurrent flushing of the face and redness, foreign-body sensation, and blurred vision in both eyes. These symptoms had persisted for 6 years, with intermittent remissions lasting up to 12 weeks. The best corrected visual acuity was 20/20 in the right eye and 20/25 in the left eye. Slit-lamp examination revealed telangiectasia with hyperemia of the eyelid margins, conjunctival hyperemia, and superficial circular neovascularization of the cornea in both eyes, with corneal infiltrate in the right eye (Panel A, arrow) and pseudopterygium in the left eye (Panel B). Corneal topography revealed high irregular corneal surfaces that were consistent with astigmatism and pseudokeratoconus Rosacea typically manifests as transient erythema of the face, and many subtypes of rosacea have been categorized, including ocular rosacea. The patient had a response to 10 days of treatment with oral doxycycline and topical dexamethasone, frequent use of artificial tears, and eyelid hygiene. At 4 weeks of follow-up, the ocular hyperemia was reduced and the corneal infiltrate had resolved substantially (Panels C and D show the right eye and left eye, respectively). Ophthalmologic evaluation at 30 months of follow-up revealed a stable ocular state with minimal signs of inflammation.