Ocular Rosacea in Children

Written by on September 28, 2005 in Ocular Rosacea with 7 Comments

According to this paper, ocular rosacea in children may be misdiagnosed as being viral or bacterial in origin. The clue of skin involvement (ie. rosacea papules and pustules on the face) is often missing in children, making the correct ocular rosacea diagnosis more difficult. Thankfully children do seem to respond to conventional ocular rosacea treatments, so did well when prescribed oral antibiotics like doryx and erythromycin and eye drops containing antibiotics or steroids.

Ocular rosacea in childhood, American Journal of Ophthalmology. 2004 Jan;Volume 137, Issue 1, Pages 138-44.

PURPOSE: To describe the clinical characteristics and treatment response of ocular rosacea in the pediatric population.

DESIGN: Retrospective case series.

METHODS: The clinic charts of consecutive pediatric cases of ocular rosacea were evaluated over a 34-month period. Minimal diagnostic inclusion criteria were the presence of posterior eyelid inflammation including meibomian gland inspissation and lid margin telangiectasis, in conjunction with conjunctival injection or episcleritis.

RESULTS: Six patients ranged from 3 to 12 years of age at presentation. All shared a long history of ocular irritation and photophobia. Five patients (83%) were female and had bilateral involvement. Eyelid telangiectases and meibomian gland disease were present in all cases. Three patients (50%) had sterile corneal ulcers. Only two patients (33%) had cutaneous involvement at the time of diagnosis.

All patients experienced significant improvement with a combination of oral antibiotics (doxycycline or erythromycin), with or without topical antibiotics (erythromycin or bacitracin) or topical steroids (fluorometholone).

CONCLUSION: Ocular rosacea in children may be misdiagnosed as viral or bacterial infections. Unlike in adults, associated cutaneous changes are uncommon. Most disease is bilateral, although involvement may be asymmetric.

Response to conventional treatment is excellent, although long-term treatment may be necessary to prevent relapses.

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

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7 Reader Comments

  1. I had severe eye problems as a teenager – irritated, infected eyes constantly. I would also have bouts of total redness, like from an injury, not just red blood vessels. When I was 17, I went to the eye doctor for irritated eyes, and ended up in surgery for a hole in my eye. I was in the hospital for a week on major antibiotics after the surgery. About 6 months later, the other eye developed a hole, this time right in the center of my cornea. It was suggested to me by my parents and doctor, that possibly I had somehow done this to myself.(yeah, right.) Could it have been my ocular rosacea? I am now 43 and have chronic chalazions and dry eyes. If you have any ideas about rosacea and this kind of problem in teens, I would appreciate it. It would certainly clear up a lot of nagging questions for me! Thank you, Sheri Kennedy


    My daugther is sufers from rosasea since she had 3 years old.we visited different doctors wihout any luck.she had eyes infected very offen.we tried diferent medication and antibiotict pads but condition is getting worse.she is 12 years old and observed that her face condition is severe
    i would appreciate it if you have any recomendation.

  3. littlemermaid says:

    Ileanajavech, So sorry to hear this – my daughter is same age, same problems: eyes under control with steroid, skin worsening. Glad to correspond with any child ocular rosacea parents (personal message or boards). Sounds like poor Sheri had corneal erosions, probably undiagnosed and untreated blepharitis/dry eye.

  4. Rochelle says:


    My 10 year old has just been diagnoised with Ocular Rosacea, this is new to me and I am having difficulty understanding and accepting this. I would like to chat to other parents in a similar situation.


  5. littlemermaid says:

    Rochelle, and any others: please can we compare notes and talk through Personal Message or on ocular rosacea forums – either in Rosacea Support Community (click top left), or in DryEyeTalk at the wonderful Dry Eye Zone website.

  6. Hi Rochelle,

    Sorry to hear about the diagnosis of your child. It can be a real shock. One positive is that when you have a good diagnosis you can get access to the best known treatments straight away.

    You may find the following useful when looking for more information.

    A support forum post Childhood Ocular Rosacea and also a forum devoted to Ocular Rosacea itself.

    all the best,

  7. karenh33 says:

    my daughter has had it since she was about 16 months old, and she is 5 now. she seems to have the worst flare ups during the summer. she uses an ointment on her lids, and we go back & forth between alrex eye drops & lotemax eye drops.

    anyone else have any luck with anything?

    does diet affect this?

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