Restasis More Effective Than Doxycycline for Ocular Rosacea

Does this look like your eye? A little red, a little irritated, red rims along the lash margin?  That's the calling card of chronic inflammation caused by ocular rosacea (a type of  chronic dry eye). via

Do you have red rimmed eyes and eyelids?  Suffer from recurrent styes? Watering? Burning? Foreign body sensation? Puffy eyelids? Light sensitivity? If you answered yes to a few of these questions, chances are you have a type of inflammatory dry eye condition we refer to as ocular rosacea.  Ocular rosacea is a very common finding; studies suggest the incidence of ocular rosacea could be as high as 72% of patients with rosacea, and many of us with rosacea are undiagnosed (Chronic facial redness and flushing?  You've probably got it and just haven't been formally diagnosed!).  For years we've been treating ocular rosacea-related dry eye with lid hygiene, artificial tears, and more recently pulsing doses of oral doxycycline used to target inflammation more-so than for any antibacterial properties.  But a new study published in the International Journal of Ophthalmology last month suggests that Restasis, an anti-inflammatory eye drop used for treating dry eye, may be even more effective than our current gold standard treatment of oral doxycycline pulsed for months at a time.

The study followed 38 patients with diagnosed rosacea and ocular rosacea signs and symptoms.  The group was split evenly with 19 patients being started on Restasis eye drops taken twice daily for 3 months, and the other 19 patients being placed on 100 mg oral doxycycline taken twice daily for one month, then once daily for the two months.  All patients were instructed to use daily eyelid hygiene and artificial tears 4 times a day throughout the study period.  Before the study began and then monthly thereafter, patients were scored on symptoms (burning? watering?) and clinical signs (eyelid redness? corneal staining?) by a group of ophthalmologists.  Standard protocol dry eye testing was also performed at these visits, including OSDI surveys, Schirmer's Test and tear break up time.

Red, inflamed meibomian glands can't secrete tear film regularly as you blink,  causing dryness, burning, watering, and foreign body sensation.  That's  why a vital part of dry eye treatment includes lid hygiene and chronic use of  anti-inflammatory medications, be they topical like Restasis or oral like doxycycline.