Blepharitis

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Background

Clinical Features

  • 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 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

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