II. Types
- Anterior Blepharitis
- Affects base of eyelashes
- Associated with staphylococcal infection or Seborrhea
- Posterior Blepharitis
- Affects meibomian gland openings
- Associated with meibomian gland dysfunction
III. Symptoms
- Pruritus
- Local irritation and burning
IV. Signs
- Inflammation of Eyelid margin at the lash follicles
- Moderate lid swelling along lash line
- Lower Eyelid is usually more affected
- Soft, oily Yellow SkinScaling
V. Differential Diagnosis
VI. Associated Conditions
- Seborrheic Dermatitis
- Staphylococcal infection
- Rosacea
- Sjogren's Syndrome
VII. Labs
-
Eyelid margin culture
- Indicated in recurrent anterior Blepharitis
- Biopsy
- Indicated in refractory cases where Skin Cancer is considered
VIII. Management
- Clean lid margins twice daily
- Pull lower lid down to scrub against orbital rim
- Apply warm compress for 2 minutes
- Loosens debris
- Helpful in severe Blepharitis
- Gently massage posterior lid to express meibomian gland contents
- Scrub lid margins with warm cloth
- Scrub lashes and lid margins with dilute baby Shampoo on cotton swab
- Wipe lid margins with warm cloth after scrubbing
- Acute infectious flare-up (e.g. staphylococcal Blepharitis)
- Erythromycin or Bacitracin ophthalmic ointment to lid margin at bedtime for 1-2 weeks
- Meibomian gland dysfunction
- Tetracycline 250 mg four times daily orally for 4 weeks or
- Doxycycline 100 mg twice daily orally for 4 weeks
- Refractory cases
- Consider brief use of Topical Corticosteroids (e.g. Tridesilon 0.05% bid for 5-10 days)
- Treat associated Seborrheic Dermatitis
IX. Complications
- Eyelash loss
- Eyelash loss with Corneal scarring