Recognizing Paediatric Ocular Rosacea: Clinical Spectrum, Diagnostic Clues, and Treatment Outcomes.

Purpose

To evaluate demographic and clinical characteristics, diagnostic clues, and treatment outcomes among paediatric patients with ocular rosacea.

Methods

Medical records of patients aged ≤ 16 years diagnosed with ocular rosacea between 2020 and 2026 were retrospectively reviewed. Demographic characteristics, presenting symptoms, eyelid and corneal findings, dermatological involvement, diagnostic delay, treatment response, recurrence, and follow-up outcomes were recorded. Disease severity at the initial examination and after treatment was evaluated using the clinical severity score described by Audelan et al. graded on a 0-4 scale.

Results

Thirty-one patients with 62 eyes were included. The female-to-male ratio was 22/9, and the mean age was 7.7 ± 4.6 (1-16) years. The most common presenting symptom was burning and/or stinging (58.1%). Blepharitis was the most common eyelid manifestation (98.4%). Corneal and dermatologic involvement were observed in 71.0% of eyes and 54.8% of patients, respectively. The mean interval between symptom onset and diagnosis was 13.2 ± 12.1(20 days-36 months) months. Three patients (9.7%) had previously been treated as having herpetic keratitis. Mean follow-up duration was 10.2 ± 10.7 (1-36) months. The mean clinical severity score decreased significantly from 2.52 ± 1.16 to 1.34 ± 1.39 after treatment (p < 0.001), with improvement in 47 eyes (75.8%). No recurrence was documented during follow-up period.

Conclusion

Paediatric ocular rosacea is an underrecognized ocular surface disease with a broad clinical spectrum and often a delayed diagnosis. A standardized clinical severity score may provide a common language for grading and monitoring. Early recognition and appropriate long-term management may help reduce morbidity.