Eye Lid Disease (blepharitis)

04/08/2014 by admin | Ophthalmology

Definition: is an inflammation of the eyelids that involves the edges of the eyelids and eyelash hair follicles.

Classification / type of disease:It may be classified as seborrhoeic, staphylocccal, mixed, posterior or meiobomitis, or parasitic

Staphylococcal blepharitis: caused by infection of the anterior portion of the eyelid by Staphylococcal bacteria. As the infection progresses, the sufferer may begin to notice a foreign body sensation, matting of the lashes, and burning.

  • Staphylococcal blepharitis is a more severe condition which may start in childhood and continue through adulthood. It is commonly recurrent and it requires special medical care.
  • In cases of blepharitis caused by Staphylococcus aureus, the presence of a collarette (a ring-like formation around the lash shaft) can be observed. This is the main sign of this particular condition. Other specific symptoms include loss of eyelashes or broken eyelashes.
  • Tx= Chloramphenicol ointment. Fusidic acid is usually the choice of antibiotics in cases when Chloramphenicol is contraindicated.

Posterior blepharitis or rosacea-associated blepharitis

  • The most common type of blepharitis is often found in people with a Rosacea skin type. The oil glands in the lid of rosacea sufferers secrete a modified oil which leads to inflammation at the meibomian gland openings which are found at the edge of the lid.

Epidemiology:

Presenting symptoms / signs:

  • Redness
  • Flaking of skin
  • Crusting at the lid margins
  • Cysts at the lid margin
  • Debris in the tear film
  • Gritty sensation of the eye
  • Reduced vision
  • Itching
  • Irritation and burning
  • Foreign body sensation
  • Eye dryness
  • Pain wearing contacts
  • Ulcerative areas and bleeding
  • Photophobia
  • Styes/chalazia
  • Clumping of eye lashes

Diagnostic investigations: 

Aetiology: rosacea, seborrhoea, oily skin, dandruff or dry eyes.

Pathophysiology:

Transmission

Treatment / management: 

  • Daily routine of lid margin hygiene.
  • An alternative after washing is to coat the eyelids with a good quality hair condition –  Leave in place for several minutes then rinse.
  • If conventional treatments for blepharitis do not bring relief, patients may consider allergy testing and ocular antihistamines
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