Topical antibiotics may also be recommended and allow for effective management of the ocular form of rosacea. For instance, tetracycline, an antibiotic from the cycline family, can be prescribed in the form of eye drops. Additionally, fluoroquinolone in eye drops, fusidic acid, and the metronidazole in gel form can also be prescribed.
Furthermore, topical cyclosporine can also be used. This is a cyclic polypeptide immunomodulator with immunosuppressive and anti-inflammatory properties. It is passively absorbed by T lymphocyte infiltrates in the cornea and conjunctiva, leading to the inactivation of calcineurin phosphatase. This inactivation results in the inhibition of pro-inflammatory cytokine production, such as IL-2 and T-cell growth factor (TCGF), and stimulates the release of anti-inflammatory cytokines.
In recent years, new active ingredients have demonstrated their effectiveness in treating ocular rosacea. They are now part of the prescribed treatments to manage the disease. In a study by BONINI in 2013, thetopical application of azithromycin was studied as a new treatment for rosacea. This study measured the Oxford score to quantify the damage present on the epithelial surface in patients suffering from dry eye.
Furthermore, the TBUT (Tear Film Break-up Time) or the time it takes for the tear film to break up was measured, as well as the condition of the Meibomian glands and the reduction of rosacea symptoms. After one month of daily treatment, a significant improvement was observed in patients. Therefore, topical application of azithromycin could be used to treat ocular rosacea over a relatively short period, either alone or in addition to another treatment, under the advice and prescription of a healthcare professional.