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Purpose <p>To present that in some cases of ocular rosacea, early initiation of systemic steroids may be successful in stopping the progression and preventing feared complications.</p> Case presentation <p>An 18-year-old male was admitted to our clinic with complaints of recurrent ocular redness and irritation. The slit lamp examination revealed conjunctival injection, limbal stem cell deficiency (LSCD) and corneal scarring in both eyes. The patient was diagnosed with ocular rosacea, and he was initiated on a regimen of systemic doxycycline (100&#xa0;mg twice daily), topical loteprednol etabonate-tobramycin combination (0.5% − 0.3%), cyclosporine (0.05% cyclosporine A), preservative-free artificial tears. One month later, descemetocele occurred in the paracentral cornea of ​​the patient’s right eye. Amniotic membrane transplantation (AMT) was applied. Despite the administration of conservative treatment, stromal melting progressed, resulting in a full-thickness corneal perforation. Consequently, corneal patch graft application was performed. In the follow-up of the patient, a newly developed descemetocele was observed in both eyes. The application of bandage contact lenses, topical medication, and AMT resulted in the cessation of stromal melting progression. The ocular findings proved refractory to topical treatments and systemic doxycycline. Consequently, a systemic corticosteroid (methylprednisolone 1&#xa0;mg/kg) was initiated. The patient’s systemic corticosteroid treatment was gradually tapered, and at the patient’s last follow-up one year later, the cornea was intact in both eyes and the anterior chamber depth was normal.</p> Conclusion <p>In such cases where worsening occurs despite all treatments, early initiation of systemic steroids may be successful in stopping the progression and preventing the feared complications.</p>

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Refractory Ocular Rosacea Requiring Systemic Immunosuppression and Multiple Surgical Interventions: Case Report

  • 期刊论文

  • 发表日期：

    2026年2月27日

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  • Seray Sahin,
  • Ayda Acar,
  • Ozlem Barut Selver

摘要

Purpose

To present that in some cases of ocular rosacea, early initiation of systemic steroids may be successful in stopping the progression and preventing feared complications.

Case presentation

An 18-year-old male was admitted to our clinic with complaints of recurrent ocular redness and irritation. The slit lamp examination revealed conjunctival injection, limbal stem cell deficiency (LSCD) and corneal scarring in both eyes. The patient was diagnosed with ocular rosacea, and he was initiated on a regimen of systemic doxycycline (100 mg twice daily), topical loteprednol etabonate-tobramycin combination (0.5% − 0.3%), cyclosporine (0.05% cyclosporine A), preservative-free artificial tears. One month later, descemetocele occurred in the paracentral cornea of ​​the patient’s right eye. Amniotic membrane transplantation (AMT) was applied. Despite the administration of conservative treatment, stromal melting progressed, resulting in a full-thickness corneal perforation. Consequently, corneal patch graft application was performed. In the follow-up of the patient, a newly developed descemetocele was observed in both eyes. The application of bandage contact lenses, topical medication, and AMT resulted in the cessation of stromal melting progression. The ocular findings proved refractory to topical treatments and systemic doxycycline. Consequently, a systemic corticosteroid (methylprednisolone 1 mg/kg) was initiated. The patient’s systemic corticosteroid treatment was gradually tapered, and at the patient’s last follow-up one year later, the cornea was intact in both eyes and the anterior chamber depth was normal.

Conclusion

In such cases where worsening occurs despite all treatments, early initiation of systemic steroids may be successful in stopping the progression and preventing the feared complications.