A Diagnostic Test for Ocular Rosacea

Written by on December 1, 2005 in Ocular Rosacea with 9 Comments

There is no established diagnostic test for ocular rosacea. This holds back both the treatment and research into ocular rosacea.

This research was funded by the NRS ; in 2004 Dr. Mannis and Dr. Alvarenga received $21,419 to study tear film alterations in ocular rosacea. Oligosaccharides are short chain sugar molecules.

This research might well lead to the creation of a definitive diagnostic test for ocular rosacea.

The paper’s conclusion “The high abundance of oligosaccharides in the tear fluid of patients with rosacea may lead to an objective diagnostic marker for the disease.” is good news for ocular rosacea sufferers.

A related patent to this research is described here: Ocular rosacea: Oligosaccharide Based Treatments

Glycomics Analyses of Tear Fluid for the Diagnostic Detection of Ocular Rosacea,

Journal Proteome Research, 2005 Dec 12;4(6):1981-1987,

An HJ, Ninonuevo M, Aguilan J, Liu H, Lebrilla CB, Alvarenga LS, Mannis MJ, Department of Chemistry, University of California, Davis, California 95616, USA.

Abstract: A Glycomics approach to detect disease is illustrated in the analyses of human tear fluid for rosacea.

The diagnosis of ocular rosacea is particularly challenging in a subgroup of patients that do not present with typical facial skin findings but have ocular signs and symptoms. Indeed, up to 90% of patients with ocular rosacea may have neither obvious roseatic skin changes nor a previous diagnosis of rosacea.

Tear fluid was collected from 37 subjects (21 controls and 16 patients with ocular rosacea) after conjunctival stimulation with filter (Schirmer) paper.

O-linked oligosaccharides were released from tear fluid by -elimination and then purified using solid-phase extraction. Mass spectra were recorded on an external source HiResMALDI with a 7.0 T magnet. Mass spectra were obtained in both the positive and negative modes. However, signals were stronger in the negative mode.

Tear fluid samples from rosacea patients yielded distinctive clusters of peaks that extend to higher masses.

Patients with rosacea presented several oligomeric series that were not found in the controls. To discriminate the ocular rosacea cases from the normal controls, the sum of absolute intensities of 13 series corresponding to nearly 50 identified mass spectrum peaks was used.

Thirty-six out of the 37 samples were correctly classified. This yields a sensitivity of 100% (95% CI 79.5-100) and specificity of 95.2% (95% CI 76.2-99.9).

The high abundance of oligosaccharides in the tear fluid of patients with rosacea may lead to an objective diagnostic marker for the disease.

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About the Author

About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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9 Reader Comments

  1. carole anthony says:

    What is the treatment for ocular rosaces?

  2. David Pascoe says:

    Hi Carole,

    Lid scrubs and compresses, oral and topical antibiotics are some of usual starting points. See Treating Ocular Rosacea for more information.


  3. Lori says:

    2 questions please,
    Is Meimbomian gland dysfunction and Ocular Rosacea the same?
    I am having splitting headaches in the right eye and frontal head. Is this related to one of these disorders?
    I have been given Systane Balance also and dx with Meimbomian dysfunction but eye doctor thinks it is Ocular Rosacea because I battle with facial Rosacea. Should I seek further treatment and dx?
    Sorry that’s 3 questions…

  4. David Pascoe says:

    Hi Lori,

    Like facial rosacea, the term ocular rosacea is a bit of an umbrella term. Meibomian gland dysfunction is not the same thing as rosacea, but is often related to it.

    An ophthalmologist ought to be able to help you treat both conditions.

    The official classification system for ocular rosacea says:

    The diagnosis of ocular rosacea should be considered when a patient’s eyes have one or more of the following signs and symptoms:

    watery or bloodshot appearance (interpalpebral conjunctival hyperemia),
    foreign body sensation,
    burning or stinging,
    light sensitivity,
    blurred vision,
    telangiectases of the conjunctiva and lid margin, or lid and
    periocular erythema.

    Also “Meibomian gland dysfunction presenting as chalazion or chronic staphylococcal infection as manifested by hordeolum (stye) are common signs of rosacea-related ocular disease.”


  5. Liz lee says:

    I am looking for a doctor in the Dallas area that has expertise in the treatment of ocular rosecea. Can anyone suggest one?

  6. susan says:

    I got both facial rosacea and ocular rosacea from prednisone taken orally because I had a severe reaction to the injections I received at our NHS pain clinic ( I had spinal problems ) the injections contained a steroid to make them longer lasting. This was unbeknownst to me or I would have refused to have them. The steroid in them caused my pituitary gland to cease working and I got acute adrenal failure, where upon I was prescribed oral prednisone as I had no immune system . I ballooned from a British size 12 to 21st one of pure flab, I had had five children and always had a great figure. I got steroid psychosis not became a recluse for 4 years only going out to the Endocrinology clinic with my husband. My husband had noticed how livid, red my face was becoming and took some pictures to show the Endocrinologist. “That’s interesting can i keep them ,” was all she said. I also found out that although I was taking prednisone for 2 years she had omitted to prescribe me the Azelastene tablets to protect my bones, but this was much later.Being a natural blonde I had beautiful porcelain skin but no longer. The flushes were painful and my skin went crimson when I moved. It takes up to 4 years for the endocrine system to return to normal. After this time span I noticed I had tightness around my chest and couldn’t breath. I was taken to hospital and diagnosed with sarcoidosis of my lungs, so yet more prednisone, it was this consultant who prescribed the alendronic acid for my bones ( sorry I misspelled it earlier )that’s when I realised hoe negligent the Endocrinologist had been.

    • susan says:

      This is the 1st part of my story the other part is just as important for all rosacea sufferers it’s somewhere on the rosacea site, maybe it’s hiding like I do because of this burns victim face of mine

  7. susan says:

    Think my story has gone on to two different sites as it doesn’t seem to follow on so is disjointed. Can this be rectified as it’s important for the content as a whole ?

  8. susan says:

    To cut a long story short my rosacea was definitely caused by oral steroid predisiloneboth the ocular and the facial even going down onto my throat and chest. It’s very sore and I can’t do a thing about it as my skin is so hypersensitive I can’t use creams. I once tried a cream especially for sensitive skin for people with rosacea and the heat from my face made me feel my skin was frying. I don’t have spots or pauses but do have a few veins showing though my whole face is affected by this horrendous burning and crimson to purplish face and neck.The dermatologist actually had the audacity to tell me to to sit with cold flannels on my face, great idea if you’ve got a party invite. Not that I’d go, even the heat emitted by this tablet I’m using or three TV sets it off sometimes very severely so life is just peachy.my eyes are so sore and feel like I’ve always got something in them ( dry eye ) they’re so red around the rims it looks as if I’m a vampire after a good gorging. I am naturally blonde and had porcelain skin so I think that the predisiloneboth has really thinned my skin to the point of transparency. I lost all the weight but am left with a lot of loose skin. My confidence is zero, I know I’m being vain but I was a good looking woman who no longer wants her photo taken and won’t look at old ones. I’m sick of being stared at, children I don’t mind as they’ll come straight out quite innocently and ask why my face is so red, I just tell them that I was ill and it’s stayed that way. They’re happy with that and go on to chat about other things. Adults don’t. The predisiloneboth left me with lots of real disabilities that maybe wouldn’t affect other people, maybe I’ve been the unlucky one in that department.i’ve had no help at all from dermatology and feel let down in general as my rosacea was completely medically generated.. The depression is crippling as is coping with a severely burning face and eyes, I was photosensitive to start with having light green eyes and avoided the sun like the plague as I got such horrible headaches with it. Ironic isn’t it that I’ve ended up with a face like this and all because I had a bad back and the steroid in the pain killing injections set off a domino effect of illness. I hate to admit it but sometimes the pain from this rosacea drives me to distraction and I could slice the skin clean off for relief. No I’m not mad just so very distraught because it’s every day. Typing this has made my eyes and face feel hot and unbearable. I want ease and I can’t get it.

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