Pediatric ocular rosacea, a misdiagnosed disease with high morbidity: Proposed diagnostic criteria

摘要

Ocular rosacea is an important and underdiagnosed chronic inflammatory disorder observed in children.A clinical spectrum ranging from chronic eyelid inflammation,recurrent ocular redness, photophobiaand/or hordeola/chalazions and conjunctival/cornealphlyctenules evolving to neovascularization and scarringmay occur. Visual impairment and consequent amblyopiaare frequent and corneal perforation although rare isthe most feared complication. Ocular manifestationsusually precede cutaneous lesions. Although few cases ofpediatric ocular rosacea (POR) have been reported in theliterature, many cases must have been underdiagnosedor misdiagnosed. The delay in diagnosis is greater thanone year in the large majority of cases and may lead toserious ocular sequelae. This review aims to highlightthe clinical features of POR, its epidemiology, easydiagnosis and effective treatment. We also propose newdiagnostic criteria, in which at least three of the fiveclinical criteria must be present: (1) Chronic or recurrentkeratoconjunctivitis and/or red eye and/or photophobia;(2) Chronic or recurrent blepharitis and/or chalazia/hordeola; (3) Eyelid telangiectasia documented by anophthalmologist; (4) Primary periorificial dermatitis and/or primary features of rosacea; and (5) Positive familialhistory of cutaneous and/or ocular rosacea.