Anti-wrinkle creams on the face and around the eye area is a source of an ocular flare. We all desire to minimize the tiny wrinkles around the eyes but unfortunately the anti-aging ingredients in these creams are often too harsh and aggressive for the sensitive or delicate skin around the eye area. To topically minimize the wrinkles, apply a drop of jojoba oil at night and during the day . Also, increase the moisture around the eye area by increasing your alkaline water intake. Increasing your water intake will plump up or fill the dehydrated skin that forms the wrinkles from the deeper layers of the skin where the wrinkles actually begin to the surface to form.
Cyclophosphamide is first line in patients with severe disease or rapid progression. 12, 17, 22, 26 It should be started in conjunction with steroids and can be dosed orally or IV. 12, 17, 22, 26 A short course of pulsed IV therapy (ex. 3 days) can be particularly effective in achieving rapid control if needed, such as prior to surgery. 22 The SITE trial found that cyclophosphamide was effective in controlling inflammation in % of patients with OCP at 1 year, with % of patients on less than or equal to 10mg of prednisone. 27 Systemic complications include myelosuppression, carcinogenesis, and teratogenicity. 22, 27
More than 50% of patients with cutaneous rosacea have ocular symptoms that may include tearing, foreign body sensation, itching, photophobia, and blurred vision. Ophthalmology consultation is recommended because complications (., corneal ulcerations, scleritis, episcleritis, iritis, persistent hordeola and chalazia) may occur. 30 Blepharitis, recurrent hordeola, chalazia, and telangiectasias can affect the lid margin ( Figure 4 ) . Mild symptoms can be managed with artificial tears, warm compresses, and cleansing the eyelashes with baby shampoo. 30 Long-term consumption of omega-3 fatty acids may improve meibomian-gland dysfunction. 31 Topical ophthalmic cyclosporine drops (Restasis) demonstrate statistically significant improvement in common signs and symptoms compared with artificial tears. 19 Topical metronidazole and erythromycin may be useful for eyelid symptoms. Patients may be treated with systemic therapy using tetracyclines or azithromycin.