Frequent patient questions: Q&A

Would Ocular Rosacea typically affect both eyes? **Usually Yes. Would there be isperiod of remission or will the left lid especially continue to be red? **Inflammation can fluxuate but the rosacea gene is inherited and always present. A low, inflammatory diet seems to help some patients rosacea from having bouts of inflammation. ??Do you have any thoughts on Optimel Gel a Manuka Honey product? I listened to Dr. Toyos talk about it and he suggests it to patients for dry eyes. ** Minooka honey has a natural anti-inflammatory and anti-biotic component. It has helped many of our patients without much risk of side effects. There are no randomized control perspective studies to show. It is affective compared to other treatments that are FDA approved. However, I think it is not a bad idea to use it. Just make sure you wash it off completely in the morning if using it at night time to allow the orifice of the meibomian glands to remain open during the day as you blink. If the eye is going to be patched with Manuka honey or coconut oil, just be careful if you have an history of an autoimmune disease: There’s been one case report reported on social media of a patient with rheumatoid arthritis who had an infection after she patched the eye with Manuka honey for multiple nights at a time. Thus we recommend to alternate eyes if planning to patch the eye at night time after applying an over the counter product like Manuka honey or coconut oil. ??Is moist heat necessary in your opinion? Studies have used dry heat and moist heat. I think both are important and effective. If we could find a way to use moist heat daily without risking mold, infestation, it may be preferable, so if your skin can tolerate, washing the eyes with some warm water in the morning at night time that might be a good alternative. Just be careful not to hurt the skin. ??If diet (gluten, dairy, sugar) is a factor, how soon would you notice a flare up after consumption? Patients who eat, gluten sugar, dairy, and have rosacea can notice a flare a few hours after consumption. ??Can Tea Tree Oil be overdone? Yes, be careful not to use too much diluted tea tree oil on the eyelashes as some Patients’ skin may be sensitive to the use of frequent diluted tea tree oil. Some people need to use the time to the tea trail. Once a week, some people need it twice a day. Recommended frequency depends on your symptoms and the skin’s tolerance to this product. ??Would it be advised to try another Lipiflow session sooner than 6 months? Lipiflow is highly recommended every six months, especially in patients who are not able to do warm compresses daily. ??Would you change anything about my cleansing routine or the order in which it`s done? Patients vary in the way they clean their eyelids and doing the lid hygiene instructions. Our best recommendation is the one that will make it easy for you to do perform the lid, hygiene instructions perform the lid, hygiene instructions without hurting your skin. If your skin become sensitive as you age or the warm compress routine makes symptoms worse, please pause on the warm compresses and let your doctor know. The doctor will discuss alternatives such as a lipiflow, TearCare, intense, pulsed light (which is an anti-inflammatory device), and/or meibomian gland probing to help keep the oil pumping.