Research progress on ocular rosacea

Rosacea is a chronic inflammatory disease affecting the central face, with approximately 6% to 72% of patients experiencing ocular involvement. Ocular rosacea shares a similar pathogenesis with cutaneous rosacea, involving immune responses, neurovascular dysfunction, and alterations in the ocular microbiome, which contribute to inflammation and meibomian gland dysfunction. Common ocular manifestations include conjunctivitis, blepharitis, keratitis, and telangiectasia of the lid margin. However, these clinical features are nonspecific making diagnosis challenging, especially blepharokeratoconjunctivitis in children, where the absence of skin symptoms often leads to misdiagnosis or missed diagnosis. Current treatment emphasizes a gradual and stepwise approach, with most management being empirical and symptomatic. Further exploration of effective, targeted treatment options is necessary. This article reviews the pathogenesis, clinical manifestations, diagnosis, and treatment advancements of ocular rosacea to enhance clinicians' understanding of this disease.