Acne Rosacea, Blepharitis and PRK: A Case History

<img src='http://newyorkvisionassociates.com/wordpress/wp-content/acnea_rosacea.jpg' alt='Acne Rosacea' align='left'/> Acne Rosacea is a skin condition that mimics regular acne, but lasts much longer and often affects adults. The condition can have substantial side affects and create secondary problems with the skin and surrounding tissue. Treatment often requires oral medication.

Blepharitis is an inflammatory condition of the eye lids that may be caused by many things including disease, allergies, pollution and even glandular anomalies.

Having laid the ground work, we had a 27 year old male enter our office requesting refractive surgery. His medical history was negative and stated that he did not take any medications. His eye exam and presurgical testing was negative except for a lid debris on his lid margins. He was instructed to use lid scrubs to clean the lids prior to surgery and PRK was performed with out incident. He continued to heal well and in less then a week he was 20/20 in each eye with the normal glare, dryness and post surgical discomfort.

He returned for a 6 week follow up complaining of blurry vision in one eye and extreme dryness and discomfort. An evaluation discovered that his right cornea was extremely hazy, had punctate keratitis, and his lids were very swollen with matted debris on them. His corneas stained and the eyes were very dry. Extensive questioning of this patient revealed that he had suffered from Acne Rosacea for many years, and was supposed to take oral antibiotics for the condition. He admitted lying to us when he came in to the office because he was afraid that we would not operate on him because of the acne rosacea.

After admonishing him for his deceit, we began treating the acne rosacea with oral Doxycycline. In addition, we prescribed topical Tobradex drops to clear up the cornea and prevent scarring and permanent vision loss. We also told him to use a regime of lid scrubs to get his lids back in working order. It took approximately 3 weeks for his corneas to clear up and for the lids to look normal again. He will have to continue his oral medications and be closely followed for at least a year to prevent a recurrence of the corneal haze.

The moral of the story is to be honest with your doctors and not try to deceive them. This individual was lucky that we were able to correct the problem, but it could have be very bad if left untreated. Systemic conditions can have significant affects on the eyes and must be carefully evaluated prior to surgery.