What is the treatment for ocular rosacea?

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Last updated: June 15, 2025View editorial policy

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From the Guidelines

Treatment for ocular rosacea should involve a combination of eyelid hygiene, artificial tears, and medications, with oral antibiotics like doxycycline being a viable option for moderate to severe cases, as recommended by the most recent and highest quality study 1.

Key Components of Treatment

  • Daily eyelid cleaning with warm compresses and gentle cleansers to remove debris and reduce inflammation
  • Preservative-free artificial tears to relieve dryness and irritation
  • Oral antibiotics like doxycycline (50-100mg once or twice daily) for 6-12 weeks, which have anti-inflammatory properties beyond their antimicrobial effects 1
  • Topical medications such as metronidazole gel or cyclosporine eye drops (Restasis) to reduce inflammation
  • Avoiding triggers like spicy foods, alcohol, extreme temperatures, and harsh skincare products
  • Omega-3 fatty acid supplements to help reduce inflammation

Importance of Follow-up

Regular follow-up with an eye care specialist is essential, as ocular rosacea is a chronic condition that requires ongoing management to prevent complications like corneal damage 1.

Treatment Approach

The treatment approach should be individualized, taking into account the patient's specific needs and concerns, and may involve a combination of treatments based on disease activity, severity, and presenting features 1.

Recent Recommendations

The most recent study 1 recommends treatments including eyelid hygiene, warm compresses, systemic tetracyclines, topical corticosteroids and cyclosporine, topical metronidazole creams and ointment, mechanical thermal pulsations, and intense pulse light therapy for rosacea conjunctivitis.

From the FDA Drug Label

Loteprednol etabonate ophthalmic suspension is indicated for the treatment of steroid-responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitides, when the inherent hazard of steroid use is accepted to obtain an advisable diminution in edema and inflammation The treatment for ocular rosacea is loteprednol etabonate ophthalmic suspension, which is indicated for the treatment of steroid-responsive inflammatory conditions, including acne rosacea 2.

  • Key points:
    • Loteprednol etabonate is used to treat steroid-responsive inflammatory conditions
    • It is indicated for the treatment of acne rosacea
    • The use of loteprednol etabonate should be weighed against the potential risks, including increased intraocular pressure (IOP).

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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