Understanding the Origins of Ocular Rosacea

Ocular rosacea — inflammation that causes redness, burning and itching of the eyes — has no cure, but the right treatments can help control its symptoms and prevent vision-threatening complications.

According to the National Rosacea Society (NRS), an estimated 16 million Americans suffer from rosacea, a widespread but poorly understood disorder, with about half of them also having ocular rosacea. With the aid of a grant from the NRS, Sezen Karakus, M.D., an assistant professor of ophthalmology at Wilmer Eye Institute, Johns Hopkins Medicine, is looking into the role of the ocular surface microbiome in the pathogenesis of rosacea.

Current treatments for ocular rosacea work only some of the time, and Karakus hopes determining the origins of the disease could lead to more targeted treatments.

Karakus has teamed up with Noori Kim, M.D. of Johns Hopkins’ Department of Dermatology to conduct research that will explore the cause of the condition. “There are a lot of hypotheses out there, but there is no known proven mechanism causing this inflammation,” she says. “When this inflammation is not recognized in a timely fashion, unfortunately it could lead to significant problems and threaten vision.”

The NRS grant is given to increase knowledge and understanding of the potential causes and other key aspects of rosacea that may lead to improvements in its treatment, prevention or potential cure. “NRS-supported investigations have eased the lives of more sufferers than ever of this widespread and troubling disorder,” said Mark Mannis, chairman of ophthalmology at the University of California-Davis and a member of the NRS Medical Advisory Board, in a press release. “Continually advancing knowledge has led to many new therapies targeted to the wide variety of rosacea’s signs and symptoms.”

Karakus says it is notable that an ophthalmologist received a grant from the National Rosacea Society because it helps raise awareness that rosacea can lead to ocular disease, and there is a need for research on the condition from an eye perspective. By researching patients with rosacea, she hopes she can build upon that perspective.

For Karakus, the grant will help her and her team complete patient enrollment for their study and begin to collect and analyze data over the next year. “This is the very first step right now,” she says. “But the idea will be to understand what differences in microbiome communities are associated with eye inflammation, and then we could find better treatments for each patient.”