Assessment of Dry Eye Disease in Patients with Rosacea: A Cross-Sectional Study
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Keywords
Rosacea, Dry Eye Disease, Ocular Rosacea, Meibomian Gland Dysfunction, OSDI, Schirmer's Test, Tear Film Break-Up Time
Abstract
Background: Rosacea is a chronic inflammatory skin disorder that commonly affects the central face and is frequently associated with ocular manifestations. Ocular involvement may result in tear film instability, meibomian gland dysfunction, and dry eye disease (DED), significantly affecting patients' quality of life. Despite its clinical importance, ocular rosacea often remains underdiagnosed.
Aim: To assess the prevalence and severity of dry eye disease in patients with rosacea and to evaluate associated ocular surface abnormalities.
Materials and Methods: This hospital-based cross-sectional study included 100 patients with clinically diagnosed rosacea. All participants underwent detailed dermatological and ophthalmological examinations. Dry eye disease was assessed using the Ocular Surface Disease Index (OSDI), Schirmer's Test I, Tear Film Break-Up Time (TBUT), fluorescein staining, and evaluation of meibomian gland dysfunction. Statistical analysis was performed using SPSS version 26.0, and a p-value <0.05 was considered statistically significant.
Result: The majority of patients were females (62%), and the most common age group was 31–40 years (32%). Erythematotelangiectatic rosacea was the most prevalent subtype (42%). The most common ocular symptoms were foreign body sensation (58%), burning sensation (54%), and dryness (52%). Dry eye disease was detected in 68% of patients. Based on OSDI scores, 22% had mild, 30% had moderate, and 16% had severe dry eye disease. The mean OSDI score was 24.7 ± 11.6, mean Schirmer's test value was 9.8 ± 4.2 mm, and mean TBUT was 8.1 ± 3.4 seconds. Meibomian gland dysfunction was present in 61% of patients, blepharitis in 48%, conjunctival hyperemia in 42%, and corneal staining in 24%. A significant association was observed between dry eye disease and longer duration of rosacea (p<0.001), as well as rosacea subtype (p=0.01).
Conclusion: Dry eye disease is highly prevalent among patients with rosacea and is strongly associated with meibomian gland dysfunction and ocular surface abnormalities. Routine ophthalmological screening of rosacea patients may facilitate early diagnosis and timely management of ocular involvement, thereby reducing morbidity and improving quality of life.
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