In the last couple of years research has emerged that could lead to a diagnostic test for ocular rosacea. There is currently no physical test that can definitively diagnose ocular rosacea.
This just published abstract, tells us that researchers were able to find an abundance of “sulfated O-glycans” in the tears and saliva of ocular rosacea sufferers.
This discovery could lead to a diagnostic test for ocular rosacea.
Related conditions like dry eye have a diagnostic test called Schimer’s Test, so if ocular rosacea could have a diagnostic test it would a nice step forward in the managing of the condition.
How is Ocular Rosacea Currently Diagnosed?
According to the Standard Classification of Rosacea, the presence of the following symptoms are used to diagnose ocular rosacea.
“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,
- dryness,
- itching,
- light sensitivity,
- blurred vision,
- telangiectases of the conjunctiva and lid margin, or
- lid and periocular erythema.
Further;
- Blepharitis, conjunctivitis, and irregularity of the eyelid margins also may occur
- Meibomian gland dysfunction presenting as chalazion or chronic staphylococcal infection as manifested by hordeolum (stye) are common signs of rosacea-related ocular disease.
- Some patients may have decreased visual acuity caused by corneal complications (punctate keratitis, corneal infiltrates/ulcers, or marginal keratitis).
New Research
Rosacea News highlight some related research in 2005 in A Diagnostic Test for Ocular Rosacea, also involving Dr. Mannis, where the conclusion was that “The high abundance of oligosaccharides in the tear fluid of patients with rosacea may lead to an objective diagnostic marker for the disease.”
Dr. Mannis is credited in the Standard Classification of Rosacea, and has been friendly and helpful to online rosacea sufferers, see his interview – Ocular Rosacea: Dr. Mark J. Mannis, MD. He has also been mentioned in Rosacea News in the past; wearing contact lenses and ocular rosacea
The purpose of this study was to study changes in glycosylation in tear and saliva obtained from control and ocular rosacea patients in order to identify potential biomarkers for rosacea.
Glycomic analysis of tear and saliva in ocular rosacea patients: the search for a biomarker.
Ocul Surf. 2012 Jul;10(3):184-92 , Vieira AC, An HJ, Ozcan S, Kim JH, Lebrilla CB, Mannis MJ.
Department of Ophthalmology, University of California, Davis, CA, USA; Department of Ophthalmology, São Paulo Hospital, Federal University of São Paulo, Brazil.
Tear fluid was collected from 51 subjects (28 healthy controls and 23 patients with ocular rosacea).
Saliva was collected from 42 of the same subjects (25 controls and 17 patients).
Pooled and individual samples were examined to determine overall glycan profiles and individual variations in glycosylation. O-and N- glycans were released from both patients and control subjects.
Released glycans were purified and enriched by solid-phase extraction (SPE) with graphitized carbon. Glycans were eluted based on glycan size and polarity. SPE fractions were then analyzed by high-resolution mass spectrometry. Glycan compositions were assigned by accurate masses. Their structures were further elucidated by tandem mass spectrometric using collision-induced dissociation (CID), and specific linkage information was obtained by exoglycosidase digestion.
N- and O-glycans were released from 20-μL samples without protein identification, separation, and purification.
Approximately 50 N-glycans and 70 O-glycans were globally profiled by mass spectrometry. Most N-glycans were highly fucosylated, while O-glycans were sulfated.
Normal tear fluid and saliva contain highly fucosylated glycans.
The numbers of sulfated glycans were dramatically increased in tear and saliva of rosacea patients compared to controls.
Glycans found in tear and saliva from roseatic patients present highly quantitative similarity.
The abundance of highly fucosylated N-glycans in the control samples and sulfated O-glycans in ocular rosacea patient samples may lead to the discovery of an objective diagnostic marker for the disease.
I appreciate having just now found your support website. I live in New Orleans and following Katrina, I began noticing a pesky rash-like problem on my face. I went to my dermatologist, who said she couldn’t diagnose the rash, but prescribed a generic inflammation ointment to apply. That didn’t help, so I began to use over-the-counter medicines to treat my symptoms. Some of my remedies included Witch-hazel, alcohol, moisturizing cream, Vaseline, acne treatments, poison ivy treatment, etc. Needless to say, none of that worked. On the contrary, as the months and years passed, my conditioned worsened to the point that I felt I was constantly infected with poison oak or ivy all over my face. Over the years, I continued to see my dermatologist, who still had no clue what I’d been stricken with. My life began to fall apart. I was always so embarrassed about the state of my horrible skin, that I rarely left my home except when it was absolutely necessary.
One day, while at my dentist, I mentioned that I’d almost cancelled my appointment due to the state of my complexion. He looked at my face and both he and his assistant said in unison, “That’s Rosacea.”
“I have several patients with this condition”, my dentist told me.
I was dumbfounded! I’d been going to a dermatologist who, for more than seven years, had not been able to diagnose my problem – even as it continued to worsen.
I’d never heard of Rosacea, but as soon as I returned home from my dental appointment, I headed straight for my computer to do some research. The information I found on the internet blew my mind. I found that the symptoms matched what I’d been experiencing for so many years – and I could follow the worsening symptoms as they’d progressed over time. I also learned that the things I’d been doing on my own (for which I’d gotten permission from my Dr. ahead of time), were all contra-indicated with Rosacea!
I’ve begun a new regime with another dermatologist, and although there is always inflammation on my face, I’ve been able to control it somewhat by paying close attention to the things which set off it’s ‘staged process’ of inflammation (primarily overheating, sunlight and sweating, and stress.
I’ve looked everywhere here in New Orleans for a support group, but no luck. That’s why I’m so pleased to find your site!
Thank you,
Polly