Current evidence suggests that there is no definitive link between bacterial or microbial pathogens and rosacea. Rosacea is believed to result from an inflammatory disease. Studies have shown that modified-release 40-mg oral doxycycline once daily reduces inflammatory lesions in patients with papulopustular rosacea without producing antibiotic selection pressure, even following months of treatment. Likewise, studies have shown that this same low-dose regimen is effective in treating ocular rosacea. The Global Rosacea Consensus panel notes that where available, the 40-mg dose should be used for rosacea versus the higher antimicrobial dose.
Topical antifungal agents are not an appropriate or mainstay treatment for ocular rosacea. Macrolides have been shown to exhibit both anti-inflammatory and immunomodulatory effects. Though data are limited in the treatment of ocular rosacea, oral formulations of both doxycycline and azithromycin have been shown to be effective.
For more on the treatment of ocular rosacea, read here.
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Cite this: Christopher J. Rapuano. Fast Five Quiz: Ocular Rosacea - Medscape - Jun 04, 2019.