If you're bothered by irritation, burning or a gritty feeling and redness in your eyes, you're not alone. Winter can bring a host of special challenges for rosacea patients, and the effects of dry eye head the list for many.

"Millions of people suffer from dry eye, and it accounts for 17 percent of all ophthalmologic visits," said Dr. Marian Macsai, chairman of ophthalmology at Northwestern University. "We definitely see more of it during the winter months because of the dryness of the environment, and it often accompanies rosacea."

Dr. Macsai explained that dry eye is either an inability to produce natural tears, or occurs because the oily (lipid) layer in the tear film is unhealthy or incomplete. A dry and windy environment can also cause more rapid evaporation of the aqueous layer of tears. In patients with eye (ocular) manifestations of rosacea, this condition is frequently made worse by blockage of the meibomian glands at the base of the eyelashes, which produce the lipids that hold the moisture on the surface of the eye.

In a recent National Rosacea Society survey of 1,780 rosacea patients reporting ocular symptoms, 95 percent said their eyes had felt dry, gritty or irritated, yet only 28 percent said they had been diagnosed with ocular rosacea.

"If the symptoms of ocular rosacea persist, it's a good idea to make an appointment with an ophthalmologist," said Dr. Macsai. Left untreated, patients with severe ocular rosacea could endure potentially serious consequences, such as scarring within the eyelid or corneal damage that could lead to decreased vision.

For mild symptoms, Dr. Macsai advises patients to use a humidifier or other means to raise the humidity at home or in work environments. She also noted that artificial tears are available at drugstores to moisturize the surface of the eye.

For her rosacea patients with dry eye problems, Dr. Macsai also emphasizes good eyelash hygiene to minimize blockage of the meibomian glands. She suggests a daily eyelash shampooing that can be performed at the end of a morning shower. Place a drop of baby shampoo on a wet washcloth and carefully rub it onto a closed eye to create a slight lather. Rub the washcloth gently back and forth in a horizontal motion over the upper and lower eyelashes. After shampooing the eyelashes on one eye, shampoo the eyelashes on the other eye.

Then, keeping the eyes closed, put your face under the shower water and rinse off all of the soap until the eyelashes feel squeaky-clean. Gently towel dry. This procedure may also be used in the bath or in front of the sink.

"Your doctor may also prescribe an ointment to rub into your lashes twice a day," Dr. Macsai said. "If any eye symptoms persist or worsen at any time of the year, make an appointment with an ophthalmologist."