Blepharitis: Difference between revisions

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==Background==
==Background==
*Inflammation of eyelids
*Acute (ulcerative or nonulcerative)
**Usually bacterial (typically [[staph]]), less often viral ([[VZV]], [[herpes]])
*Chronic (meibomian gland dysfunction, seborrheic blepharitis)


==Clinical Features==
==Clinical Features==
*sore/itchy
[[File:Blepharitis.jpg|thumb|Blepharitis of right eye.]]
*inflammation of lid margin with ocular irritation, matted lashes
[[File:Anterior Blepharitis.jpg|thumb|Scaling and bacterial debris at the base of the eyelashes.]]
[[File:Infant with blepharitis on the right side.jpg|thumb|Infant with blepharitis of right side.]]
*Sore/itchy
*Inflammation of lid margin with ocular irritation, matted lashes
*[[blurred vision|Blurry vision]]
*Tearing
*Crusting at the lid margins
*Distinguish anterior from posterior blepharitis using slit lamp
*Distinguish anterior from posterior blepharitis using slit lamp
**Posterior - swelling and pluggin of meibomian gland openings
**Posterior - swelling and plugging of meibomian gland openings
**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


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==Management==
==Management==
*Lid hygiene most important for both anterior and posterior blepharitis
*Lid hygiene most important for both anterior and posterior blepharitis
*Avoid eye-makeup
*Warm compresses 15min 4x/day
*Warm compresses 15min 4x/day
*Scrub with mild shampoo BID
*Scrub with mild shampoo BID
*Consider topical [[erythromycin]] or bacitracin directly onto lid margin
*Consider topical [[erythromycin]] or [[bacitracin]] directly onto lid margin
*No conclusive evidence for oral antibiotics or topical steroids
*No conclusive evidence for oral antibiotics or topical steroids



Latest revision as of 20:07, 26 September 2020

Background

  • Inflammation of eyelids
  • Acute (ulcerative or nonulcerative)
  • Chronic (meibomian gland dysfunction, seborrheic blepharitis)

Clinical Features

Blepharitis of right eye.
Scaling and bacterial debris at the base of the eyelashes.
Infant with blepharitis of right side.
  • Sore/itchy
  • Inflammation of lid margin with ocular irritation, matted lashes
  • Blurry vision
  • Tearing
  • Crusting at the lid margins
  • Distinguish anterior from posterior blepharitis using slit lamp
    • Posterior - swelling and plugging 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

No proptosis

Lid Complications

Other

Evaluation

  • Clinical diagnosis

Management

  • Lid hygiene most important for both anterior and posterior blepharitis
  • Avoid eye-makeup
  • Warm compresses 15min 4x/day
  • Scrub with mild shampoo BID
  • Consider topical erythromycin or bacitracin directly onto lid margin
  • No conclusive evidence for oral antibiotics or topical steroids

Disposition

  • Outpatient optho - chronic condition without definitive cure

See Also

References