Ocular Rosacea Is Common and Multisymptomatic

The human eye
The human eye
An updated epidemiologic perspective on ocular rosacea is provided.

The most common clinical symptoms of ocular rosacea were outlined in survey data published in the International Journal of Dermatology. Per survey responses from patients with rosacea, eye involvement was common and associated with more severe skin manifestations. The most common symptoms of ocular rosacea were dry eyes, red/itchy eyes, and the presence of styes.

A detailed online questionnaire was administered to 777 patients with rosacea across Germany. The majority of respondents were women (82.0%) and the mean age was 54 ± 11.2 years. Overall, 399 patients (51.4%) reported ocular symptoms, including redness of eyes (44.9%), itching (46.9%), dryness (27.1%), and stye or chalazion (22.6%). A total of 309 patients reported consulting with an eye specialist, among whom 140 (45.3%) were diagnosed with ocular rosacea. Most patients (56.3%) with eye symptoms were between 60 and 80 years of age. No patients over the age of 80 years reported ocular symptoms.

Eye symptoms were associated with greater skin symptom severity (P <.05), more skin flushing (P <.01), and greater self-reported levels of psychological distress (P <.01). A face swab was performed for 11.1% of respondents; ocular symptoms were present in approximately half (46.7%) of patients who tested positive for Demodex. However, the association was not statistically significant.

Results from this study outline the characteristics of ocular symptoms in patients with rosacea. Survey responses suggest to the researchers that the disease burden of rosacea is greater in patients with eye manifestations. Further research is necessary to understand the pathogenesis of ocular rosacea.

“Future studies are needed to further elaborate on the mechanisms of rosacea development and the mode of action of mentioned risk factors,” investigators wrote. “Here, immunological studies will be key to elucidate the exact triggers of this chronic inflammatory disease.”

Disclosure: Two study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Zierl S, Hildebrand JA, Guertler A, et al. Clinical clues to identify patients with ocular rosacea – a Germany-wide epidemiologic analysis. Int J Dermatol. Published online May 17, 2022. doi:10.1111/ijd.16235