A new survey by the National Rosacea Society suggests that common symptoms known as ocular rosacea, which can cause irritation or redness in the eyes of rosacea patients, may be significantly underdiagnosed.

Out of 1,780 rosacea sufferers reporting ocular symptoms, 86 percent said their eyes had appeared watery or bloodshot and 95 percent said their eyes had felt dry, gritty or irritated. Of those with watery or bloodshot eyes, only 29 percent said they had been diagnosed with ocular rosacea. Of those experiencing dryness, grittiness or irritation, only 28 percent said they had been diagnosed.

One of the reasons ocular rosacea may often go undetected is the fact that these symptoms tend to develop separately from the facial symptoms of the disorder. Thirty-eight percent of the survey respondents said their ocular symptoms developed after their facial symptoms, while 17 percent said they occurred before. Only 15 percent said eye and facial symptoms appeared at the same time, and 22 percent were unsure.

"Many people may not connect their eye symptoms with a skin disorder, and sometimes an ophthalmologist will be the first one to notice rosacea and point the patient to a dermatologist," said Dr. Guy Webster, associate professor of dermatology at Thomas Jefferson University Medical College in Philadelphia. "Ocular rosacea may be far more common than is generally recognized, and in clinical studies it has occurred in as many as 58 percent of rosacea patients."

The symptoms of ocular rosacea are often mild, and may be considered minor annoyances by many patients. Some patients, however, feel as though there is an eyelash or something gritty or foreign in their eye. In severe cases, ocular rosacea may include swollen blood vessels, inflammation of the eye or eyelid, irritation or scaling of the mucous membrane, and in rare instances even impairment of vision.

The good news is that medical therapy appears to be widely effective in improving the symptoms. Of the survey respondents who had been diagnosed with ocular rosacea, 88 percent said they had received treatment, and 90 percent of those treated said their condition had improved.

Once diagnosed, a physician will usually prescribe a combination of treatments for ocular rosacea tailored to the individual. This may include local and systemic therapy, as well as cleansing and tearing agents, all of which may be adjusted over time.