Blepharitis: Difference between revisions
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##Anterior - on external exam, material such as greasy flakes (seborrheic) or hard crust (staph) surrounds eyelashes | ##Anterior - on external exam, material such as greasy flakes (seborrheic) or hard crust (staph) surrounds eyelashes | ||
== | ==Differential Diagnosis== | ||
{{Periorbital swelling DDX}} | |||
==Treatment== | ==Treatment== | ||
Revision as of 17:25, 13 October 2014
Diagnosis
- sore/itchy
- inflammation of lid margin w/ ocular irritation, matted lashes
- Distinguish anterior from posterior blepharitis using slit lamp
- Posterior - swelling and pluggin of meibomian gland openings
- Anterior - on external exam, material such as greasy flakes (seborrheic) or hard crust (staph) surrounds eyelashes
Differential Diagnosis
Periorbital swelling
Proptosis
- Normal IOP
- Orbital cellulitis
- Orbital pseudotumor
- Orbital tumor
- Increased IOP
- Retrobulbar abscess
- Retrobulbar emphysema
- Retrobulbar hemorrhage
- Ocular compartment syndrome
- Orbital tumor
No proptosis
- Periorbital cellulitis/erysipelas
- Dacryocystitis (lacrimal duct)
- Dacryocele/Dacryocystocele
- Dacryostenosis
- Dacryoadenitis (lacrimal gland)
- Allergic reaction
- Nephrotic Syndrome (pediatrics)
Lid Complications
- Blepharitis (crusts)
- Chalazion (meibomian gland)
- Stye (hordeolum) (eyelash folicle)
Other
- Subperiosteal abscess
- Orbital abscess
- Cavernous sinus thrombosis
- Conjunctivitis
- Contact dermatitis
- Herpes zoster
- Herpes simplex
- Sarcoidosis
- Granulomatosis with polyangiitis
Treatment
- Lid hygiene most important for both anterior and posterior blepharitis
- Warm compresses 15min 4x/day
- Scrub w/ mild shampoo BID
- Consider topical erythromycin or bacitracin directly onto lid margin
- No conclusive evidence for oral antibiotics or topical steroids
- Outpt ophtho - chronic condition without definitive cure
See Also
Sources
- UpToDate