Schoolteachers are legendary for their "eagle eyes" — their uncanny ability to see a note being passed in the last row or a piece of chewing gum being placed surreptitiously in a student's mouth. So it was for Barbara Brown, a retired teacher from Virginia, until about four years ago when she began to experience severe eye irritation.

"It started with what I thought was an eye infection," Barbara said. "I got some ointment from my doctor, but it didn't get any better. He finally sent me to a specialist who diagnosed my problem as ocular rosacea."

Eye symptoms are common in rosacea patients and eye dryness is an early sign of subtype 4 (ocular) rosacea, according to a study published in the Journal of the European Academy of Dermatology and Venereology.¹

Noting that the prevalence of eye involvement in rosacea is probably higher than often presumed, Dr. E. Lazaridou and colleagues of the Aristotle University Medical School, Thessalonika, Greece, examined 100 rosacea patients for ocular signs and symptoms using two tests to determine the presence of eye dryness.

The National Rosacea Society (NRS) has awarded funding for three new studies in addition to continuing support for five ongoing studies as part of its research grants program to increase knowledge and understanding of the potential causes and other key aspects of rosacea.

Soothing cleansing and other measures in addition to medical therapy may help relieve the symptoms of subtype 4 (ocular) rosacea, according to the standard management options for rosacea recently published by the National Rosacea Society (NRS).

"Gentle care in keeping eyelids clean is especially important in keeping eyes with ocular rosacea healthy," said Dr. Marian Macsai, professor of ophthalmology at the University of Chicago and a member of the consensus committee and review panel of 26 medical experts who developed the new standard options.¹

A new study has found there may be a link between ocular rosacea and bacteria associated with Demodex mites, microscopic inhabitants of normal skin that tend to occur in much greater numbers in those with rosacea.

In the recently published study of 59 rosacea patients, Dr. Jianjing Li and colleagues at the Ocular Surface Center in Miami found a significant correlation between facial rosacea, infestation of the eyes with Demodex mites and reaction to certain mite-related organisms previously shown to stimulate an immune response in rosacea sufferers.¹

Q. Although I have rosacea, the symptoms only appear in the winter, not during the summer. Is it possible to have "winter rosacea"?

A. While many rosacea patients are affected by environmental factors that change with the seasons, what affects one person may not affect another. It may be that you are particularly sensitive to wind or frigid weather and these winter elements aggravate your rosacea.

Q. Can rosacea be on the inside of your eyelids?

Robert Angsten, an Arizona retiree, had symptoms of rosacea for about six years when his wife first noticed some redness in the area of his cheekbones. A dermatologist diagnosed the condition as rosacea. Typical of older men, however, he was unconcerned about his complexion and viewed the rosacea as little more than a nuisance until it began to affect his vision.

Although rosacea rarely appears in children, its potential occurrence should be considered during medical examinations because of the possible severity of ocular (eye) involvement, according to a report in the Archives of Dermatology.¹

Special care may be needed for rosacea patients with severe forms of ocular rosacea, according to Dr. Sandra Cremers, instructor of ophthalmology at Harvard Medical School. As part of a National Rosacea Society (NRS) research grant, she recently developed a scoring system to identify severe cases of this rosacea subtype, which may affect half of all rosacea patients.