How can rosacea lead to keratitis and corneal scarring?

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eye disease An ophthalmologist performing LASIK eye surgery.

Rosacea keratitis is a complication of acne rosacea, a condition primarily characterized by facial flushing, nodules, and pustules.1

The development of keratitis and subsequent corneal scarring in these patients is linked to an abnormal immune response. Specifically, individuals with this condition exhibit unusually high levels and irregular forms of cathelicidin, an antimicrobial protein produced by immune cells such as neutrophils and macrophages. This protein triggers the production of inflammatory molecules that drive the progression of the disease.1

As the cornea becomes inflamed, the process can lead to severe pain and the development of opacities or scarring, which ultimately impairs vision. In some cases, keratitis can also facilitate the growth of blood vessels onto or into the corneal tissue, further contributing to visual loss.1